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1

What Causes Respiratory Failure?  

MedlinePLUS

... easily move oxygen into your blood and remove carbon dioxide from your blood (gas exchange). This can cause a low oxygen level or high carbon dioxide level, or both, in your blood. Respiratory ...

2

Respiratory failure caused by giant thymolipoma.  

PubMed

The authors present the case of a 31-year-old woman with a massive anterior mediastinal tumor who presented with respiratory failure. A thoracic computed tomographic scan suggested a mediastinal lipomatous mass, and an operation was performed. Resection of the tumor resulted in immediate improvement in the patient's pulmonary status, and the histopathologic examination revealed thymolipoma. Because thymolipoma can attain enormous dimensions and compress adjacent structures, it should be immediately resected. PMID:18640359

Ceran, Sami; Tulek, Baykal; Sunam, Guven; Suerdem, Mecit

2008-08-01

3

Respiratory Failure  

MedlinePLUS

... the air sacs. This process is called gas exchange. In respiratory failure, gas exchange is impaired. Respiratory failure can be acute (short ... oxygen—into your airways and then your lungs. Rate This Content: Next >> December 19, 2011 Respiratory Failure ...

4

Respiratory Failure  

MedlinePLUS

Respiratory failure happens when not enough oxygen passes from your lungs into your blood. Your body's organs, ... brain, need oxygen-rich blood to work well. Respiratory failure also can happen if your lungs can' ...

5

Successful Use of Extracorporeal Membrane Oxygenation for Respiratory Failure Caused by Mediastinal Precursor T Lymphoblastic Lymphoma  

PubMed Central

Precursor T lymphoblastic lymphoma (T-LBL) often manifests as a mediastinal mass sometimes compressing vital structures like vessels or large airways. This case was a 40-year-old male who developed T-LBL presenting as respiratory failure caused by mediastinal T-LBL. He presented with persistent life threatening hypoxia despite tracheal intubation. We successfully managed this respiratory failure using venovenous (VV) ECMO. Induction chemotherapy was started after stabilizing oxygenation and the mediastinal lesion shrank rapidly. Respiratory failure caused by compression of the central airway by tumor is an oncologic emergency. VV ECMO may be an effective way to manage this type of respiratory failure as a bridge to chemotherapy.

Oto, Masafumi; Inadomi, Kyoko; Chosa, Toshiyuki; Uneda, Shima; Uekihara, Soichi; Yoshida, Minoru

2014-01-01

6

Chest radiographs of neonates with respiratory failure caused by congenital syphilis  

Microsoft Academic Search

Congenital syphilis still occurs in newborn babies and the prevalence has increased in recent years, especially in developing countries. This has led to an increase in the number of babies with congenital syphilis requiring intensive care for respiratory failure. The early recognition of this disease could lead to the institution of timely and appropriate treatment. In this study the radiological

C. H. Pieper; W. F. C. van Gelderen; J. Smith; G. F. Kirsten; S. Möhrcken; R. P. Gie

1995-01-01

7

Rigid spine syndrome with respiratory failure.  

PubMed Central

The pathogenesis and therapy of respiratory failure in the rigid spine syndrome are discussed in two cases who improved with respiratory assistance. In both cases, the partial pressures of oxygen and carbon dioxide were reversed in arterial blood gas analysis and %VC was less than 30%. Remission from respiratory failure has been obtained by the use of a ventilator during the night. The cause of the respiratory failure in both cases was severe restrictive respiratory dysfunction due to extreme flattening of the chest and fixation of the thorax during respiration as a result of contracture of costovertebral joints. All the previously reported cases of the rigid spine syndrome with respiratory failure died. Appropriate use of the ventilator can improve the prognosis. Images PMID:2246660

Morita, H; Kondo, K; Hoshino, K; Maruyama, K; Yanagisawa, N

1990-01-01

8

Rigid spine syndrome with respiratory failure.  

PubMed

The pathogenesis and therapy of respiratory failure in the rigid spine syndrome are discussed in two cases who improved with respiratory assistance. In both cases, the partial pressures of oxygen and carbon dioxide were reversed in arterial blood gas analysis and %VC was less than 30%. Remission from respiratory failure has been obtained by the use of a ventilator during the night. The cause of the respiratory failure in both cases was severe restrictive respiratory dysfunction due to extreme flattening of the chest and fixation of the thorax during respiration as a result of contracture of costovertebral joints. All the previously reported cases of the rigid spine syndrome with respiratory failure died. Appropriate use of the ventilator can improve the prognosis. PMID:2246660

Morita, H; Kondo, K; Hoshino, K; Maruyama, K; Yanagisawa, N

1990-09-01

9

Intensive care adult patients with severe respiratory failure caused by Influenza A (H1N1)v in Spain  

Microsoft Academic Search

INTRODUCTION: Patients with influenza A (H1N1)v infection have developed rapidly progressive lower respiratory tract disease resulting in respiratory failure. We describe the clinical and epidemiologic characteristics of the first 32 persons reported to be admitted to the intensive care unit (ICU) due to influenza A (H1N1)v infection in Spain. METHODS: We used medical chart reviews to collect data on ICU

Jordi Rello; Alejandro Rodríguez; Pedro Ibañez; Lorenzo Socias; Javier Cebrian; Asunción Marques; José Guerrero; Sergio Ruiz-Santana; Enrique Marquez; Frutos Del Nogal-Saez; Francisco Alvarez-Lerma; Sergio Martínez; Miquel Ferrer; Manuel Avellanas; Rosa Granada; Enrique Maraví-Poma; Patricia Albert; Rafael Sierra; Loreto Vidaur; Patricia Ortiz; Isidro Prieto del Portillo; Beatriz Galván; Cristóbal León-Gil

2009-01-01

10

Intensive care adult patients with severe respiratory failure caused by Influenza A (H1N1)v in Spain  

PubMed Central

Introduction Patients with influenza A (H1N1)v infection have developed rapidly progressive lower respiratory tract disease resulting in respiratory failure. We describe the clinical and epidemiologic characteristics of the first 32 persons reported to be admitted to the intensive care unit (ICU) due to influenza A (H1N1)v infection in Spain. Methods We used medical chart reviews to collect data on ICU adult patients reported in a standardized form. Influenza A (H1N1)v infection was confirmed in specimens using real-time reverse transcriptase-polymerase-chain-reaction (RT PCR) assay. Results Illness onset of the 32 patients occurred between 23 June and 31 July, 2009. The median age was 36 years (IQR = 31 - 52). Ten (31.2%) were obese, 2 (6.3%) pregnant and 16 (50%) had pre-existing medical complications. Twenty-nine (90.6%) had primary viral pneumonitis, 2 (6.3%) exacerbation of structural respiratory disease and 1 (3.1%) secondary bacterial pneumonia. Twenty-four patients (75.0%) developed multiorgan dysfunction, 7 (21.9%) received renal replacement techniques and 24 (75.0%) required mechanical ventilation. Six patients died within 28 days, with two additional late deaths. Oseltamivir administration delay ranged from 2 to 8 days after illness onset, 31.2% received high-dose (300 mg/day), and treatment duration ranged from 5 to 10 days (mean 8.0 ± 3.3). Conclusions Over a 5-week period, influenza A (H1N1)v infection led to ICU admission in 32 adult patients, with frequently observed severe hypoxemia and a relatively high case-fatality rate. Clinicians should be aware of pulmonary complications of influenza A (H1N1)v infection, particularly in pregnant and young obese but previously healthy persons. PMID:19747383

2009-01-01

11

Emergency thyroidectomy: Due to acute respiratory failure  

PubMed Central

INTRODUCTION Giant cervical and mediastinal goiter may lead to acute respiratory failure caused by laryngotracheal compression and airway obstruction. Here, we present a case admitted to the emergency service with a giant goiter along with respiratory failure and poor general health status, which required urgent surgical intervention. PRESENTATION OF CASE A 71-year-old female admitted to the emergency room with shortness of breath and poor general health status resulting from a giant cervical swelling progressively increased during the last 7 years and constituted severe respiratory failure which has become severe in the last one month. A giant nodular goiter of the left thyroid lobe extending retrosternally, causing tracheal compression, limiting the neck movements was detected with clinical examination and bedside ultrasound. Emergency thyroidectomy was planned. Fiberoptic-assisted awake nasal intubation was performed in the operating room. Emergency total thyroidectomy was performed for the life-threatening respiratory failure. Postoperative period was uneventful. She was transferred from intensive care unit to the ward on postoperative day 3 and was discharged from the hospital on the postoperative 7th day. Benign multinodular hyperplasia was reported on the histopathological report. Patient was included in routine follow-up. DISCUSSION In the present case tracheal destruction due to compression of the giant goiter was found in agreement with previous reports. Emergency thyroidectomy was performed after awake intubation since it is a common surgical option for the treatment of giant goiter causing severe airway obstruction. CONCLUSION Respiratory failure due to giant nodular goiter is a life-threatening situation and should be treated immediately by performing awake endotracheal intubation following emergency total thyroidectomy. PMID:25437688

Bayhan, Zulfu; Zeren, Sezgin; Ucar, Bercis Imge; Ozbay, Isa; Sonmez, Yalcin; Mestan, Metin; Balaban, Onur; Bayhan, Nilufer Araz; Ekici, Mehmet Fatih

2014-01-01

12

Common Cause Failure Modes  

NASA Technical Reports Server (NTRS)

High technology industries with high failure costs commonly use redundancy as a means to reduce risk. Redundant systems, whether similar or dissimilar, are susceptible to Common Cause Failures (CCF). CCF is not always considered in the design effort and, therefore, can be a major threat to success. There are several aspects to CCF which must be understood to perform an analysis which will find hidden issues that may negate redundancy. This paper will provide definition, types, a list of possible causes and some examples of CCF. Requirements and designs from NASA projects will be used in the paper as examples.

Wetherholt, Jon; Heimann, Timothy J.; Anderson, Brenda

2011-01-01

13

Respiratory acidosis  

MedlinePLUS

Ventilatory failure; Respiratory failure; Acidosis - respiratory ... Causes of respiratory acidosis include: Diseases of the airways (such as asthma and chronic obstructive lung disease ) Diseases of the chest ( ...

14

Respiratory failure in a patient with dermatomyositis  

PubMed Central

Since its original description in 1956 the association between interstitial lung disease and polymyositis (PM) and dermatomyositis (DM) has become well established. Interstitial lung disease (ILD) can be a significant complication in rheumatic diseases (RDs). Although most patients with RD do not develop clinically evident ILD, these systemic autoimmune disorders are estimated to be responsible for approximately 25% of all ILD deaths and 2% of deaths due to all respiratory causes. Radiologic abnormalities in DM are characterized by a high incidence of airspace consolidation. Non-Specific Interstitial Pneumonia (NSIP) is the most common form of lung disease, with a frequency in biopsies 4-fold greater than that of Usual Interstitial Pneumonia (UIP) in PM and a slightly smaller predominance in DM. We report a case of a female patient, 57 years old, no former smoker, whose clinical history was onset in November 2008 with asthenia with muscle and osteoarticular pain especially located in the upper limbs and then also expanded to the lower limbs. The EMG was compatible with dermatomyositis in the acute phase. The patient received therapy with steroids and tacrolimus, also making several rounds of treatment with immunoglobulin. Given the recurrence of myositis in association with signs of poorly controlled interstitial lung disease, immunosuppressive therapy with Rituximab was administered. The Computed Tomography (CT) scans showed "bronchiectasis and traction bronchiolectasis, hypodense areas consistent with the phenomena of air trapping. The pattern of interstitial lung disease with fibrotic evolution seems consistent with NSIP. The arterial blood gas analysis showed a pattern of hypoxic-hypercapnic respiratory failure (pH: 7,34, PaO2: 67 mmHg; PaCO2: 55 mmHg). As a result of an episode of marked desaturation unresponsive to supplemental oxygen at high flows we proceeded to noninvasive mechanical ventilation with Helmet for 24 hours/24. This ventilatory support was maintained for a week, with resolution of the respiratory failure. In this brief case report we want to highlight various pulmonary complications as a result of dermatomyositis. The progression of respiratory complications may also lead to a situation of respiratory failure, as in our patient, and require a noninvasive ventilatory treatment. PMID:23531196

2013-01-01

15

Non-invasive ventilation in acute respiratory failure.  

PubMed

One of the cornerstones of critical care medicine is support of the failing respiratory system. The 2 major components of managing respiratory failure are the acute intervention and the weaning process. Many of the studies to determine the optimal methods of ventilation and weaning have focused on non-invasive positive-pressure ventilation as an alternative to invasive ventilation, with various causes of acute respiratory failure. Non-invasive ventilation refers to the provision of ventilatory support to the lungs, without the use of an endotracheal airway. It has emerged as an important tool in the treatment of acute respiratory failure. Non-invasive positive ventilation has undergone a remarkable evolution over the past decades and is assuming an important role in the management of both acute and chronic respiratory failure. There is improvement in gas exchange, relief of respiratory muscle fatigue, and clinical outcome with reduced morbidity and mortality. Nevertheless, contraindications and failures need to be identified early, as delaying endotracheal intubation is associated with increased morbidity and mortality. Furthermore, although it is common practice to give intubation and mechanical ventilation, complications can result from the intubation process (damage to local tissue) and during the course of ventilation (pneumonia and sinusitis associated with ventilators), prolonging stay in intensive care, length of hospital stay and mortality in selected patients. PMID:24760814

Singh, Gurmeet; Pitoyo, Ceva W

2014-01-01

16

Respiratory failure following talc pleurodesis  

Microsoft Academic Search

Background: Sterile talc is currently the agent of choice for pleurodesis. Its success rate is excellent, and talc is generally well tolerated. However, a recent experience with fulminant pneumonitis following talc pleurodesis prompted a review of our experience.Methods: A retrospective review of patients undergoing talc pleurodesis at our institution between December 1993 and December 1997 was performed, documenting respiratory and

Dagmar H Rehse; Ralph W Aye; Michael G Florence

1999-01-01

17

Respiratory muscle strength and ventilatory failure in amyotrophic lateral sclerosis  

Microsoft Academic Search

Summary Although ventilatory failure is the most common cause of death in amyotrophic lateral sclerosis (ALS) and measurement of respiratory muscle strength (RMS) has been shown to have prognostic value, no single test of strength can predict the presence of hypercapnia reliably. RMS was measured in 81 ALS patients to evaluate the relationship between tests of RMS and the presence

R. A. Lyall; N. Donaldson; M. I. Polkey; P. N. Leigh; J. Moxham

2001-01-01

18

Rhinovirus Associated Severe Respiratory Failure in Immunocompetent Adult Patient  

PubMed Central

Rhinovirus infection is typically associated with the common cold and has rarely been reported as a cause of severe pneumonia in immunocompetent adults. A 55-year-old previous healthy woman, who consumed half a bottle of alcohol daily, presented with respiratory failure after one week of upper respiratory infection symptoms. Radiography revealed bilateral, diffuse ground glass opacity with patchy consolidation in the whole lung field; bronchoalveolar lavage fluid analysis indicated that rhinovirus was the causative organism. After five days of conservative support, the symptoms and radiographic findings began to improve. We report this rare case of rhinovirus pneumonia in an otherwise healthy host along with a review of references. PMID:25309608

Kim, Kiwook; Song, Yeon Han; Park, Joo-Hyun; Park, Hye Kyeong; Kim, Su Young; Jung, Hun; Lee, Sung-Soon

2014-01-01

19

Rhinovirus associated severe respiratory failure in immunocompetent adult patient.  

PubMed

Rhinovirus infection is typically associated with the common cold and has rarely been reported as a cause of severe pneumonia in immunocompetent adults. A 55-year-old previous healthy woman, who consumed half a bottle of alcohol daily, presented with respiratory failure after one week of upper respiratory infection symptoms. Radiography revealed bilateral, diffuse ground glass opacity with patchy consolidation in the whole lung field; bronchoalveolar lavage fluid analysis indicated that rhinovirus was the causative organism. After five days of conservative support, the symptoms and radiographic findings began to improve. We report this rare case of rhinovirus pneumonia in an otherwise healthy host along with a review of references. PMID:25309608

Kim, Kiwook; Song, Yeon Han; Park, Joo-Hyun; Park, Hye Kyeong; Kim, Su Young; Jung, Hun; Lee, Sung-Soon; Koo, Hyeon-Kyoung

2014-09-01

20

Diagnosis of muscle diseases presenting with early respiratory failure.  

PubMed

Here we describe a clinical approach and differential diagnosis for chronic muscle diseases which include early respiratory failure as a prominent feature in their presentation (i.e. respiratory failure whilst still ambulant). These patients typically present to neurology or respiratory medicine out-patient clinics and a distinct differential diagnosis of neuromuscular aetiologies should be considered. Amyotrophic lateral sclerosis and myasthenia gravis are the important non-muscle diseases to consider, but once these have been excluded there remains a challenging differential diagnosis of muscle conditions, which will be the focus of this review. The key points in the diagnosis of these disorders are being aware of relevant symptoms, which are initially caused by nocturnal hypoventilation or diaphragmatic weakness; and identifying other features which direct further investigation. Important muscle diseases to identify, because their diagnosis has disease-specific management implications, include adult-onset Pompe disease, inflammatory myopathy, and sporadic adult-onset nemaline myopathy. Cases which are due to metabolic myopathy or muscular dystrophy are important to diagnose because of their implications for genetic counselling. Myopathy from sarcoidosis and colchicine each has a single reported case with this presentation, but should be considered because they are treatable. Disorders which have recently had their genetic aetiologies identified include hereditary myopathy with early respiratory failure (due to TTN mutations), the FHL1-related syndromes, and myofibrillar myopathy due to BAG3 mutation. Recently described syndromes include oculopharyngodistal muscular dystrophy that awaits genetic characterisation. PMID:25377282

Pfeffer, Gerald; Povitz, Marcus; Gibson, G John; Chinnery, Patrick F

2014-11-01

21

Noninvasive ventilation in acute respiratory failure  

PubMed Central

After the institution of positive-pressure ventilation, the use of noninvasive ventilation (NIV) through an interface substantially increased. The first technique was continuous positive airway pressure; but, after the introduction of pressure support ventilation at the end of the 20th century, this became the main modality. Both techniques, and some others that have been recently introduced and which integrate some technological innovations, have extensively demonstrated a faster improvement of acute respiratory failure in different patient populations, avoiding endotracheal intubation and facilitating the release of conventional invasive mechanical ventilation. In acute settings, NIV is currently the first-line treatment for moderate-to-severe chronic obstructive pulmonary disease exacerbation as well as for acute cardiogenic pulmonary edema and should be considered in immunocompromised patients with acute respiratory insufficiency, in difficult weaning, and in the prevention of postextubation failure. Alternatively, it can also be used in the postoperative period and in cases of pneumonia and asthma or as a palliative treatment. NIV is currently used in a wide range of acute settings, such as critical care and emergency departments, hospital wards, palliative or pediatric units, and in pre-hospital care. It is also used as a home care therapy in patients with chronic pulmonary or sleep disorders. The appropriate selection of patients and the adaptation to the technique are the keys to success. This review essentially analyzes the evidence of benefits of NIV in different populations with acute respiratory failure and describes the main modalities, new devices, and some practical aspects of the use of this technique. PMID:25143721

Mas, Arantxa; Masip, Josep

2014-01-01

22

Acute respiratory distress caused by massive thymolipoma.  

PubMed

The authors present the case of a 40-year-old female with a massive anterior mediastinal tumor who presented with acute respiratory distress. She required emergent intubation and ventilatory support for respiratory compromise caused by lung compression. Preoperative computed tomographic scan results suggested a mediastinal lipomatous mass. Resection of the tumor resulted in immediate improvement in her pulmonary status. Because thymolipomas can attain enormous dimensions and compress adjacent structures, they should be resected at the time of diagnosis. PMID:15586609

Halkos, Michael E; Symbas, John D; Symbas, Panagiotis N

2004-11-01

23

Urinothorax: A rare cause of severe respiratory distress  

PubMed Central

A case of massive right pleural effusion in a postoperative patient of percutaneous nephrolithotomy leading to severe respiratory distress is reported. A high degree of clinical suspicion and prompt intervention by insertion of an intercostal drainage tube prevented the patient from going in to respiratory failure. The development of arrhythmias confused the picture increasing the morbidity of the patient. However, the patient was managed in an intensive care unit with intercostal chest tube insertion and antiarrhythmic agents. After correction of the specific cause of the effusion the intercostal tube was removed on the 4th day without further recurrence of the effusion. PMID:24914262

Chandra, Alka; Pathak, Amrendra; Kapur, Anu; Russia, Neha; Bhasin, Nikhil

2014-01-01

24

The successful treatment of hypercapnic respiratory failure with oral modafinil  

PubMed Central

Hypercapnic respiratory failure is common in advanced chronic obstructive pulmonary disease and is usually treated by nasal ventilation. Not all patients requiring such ventilation can tolerate it, with anxiety and phobia influencing their reaction, along with treatment failure. We report the case histories of six patients with hypercapnic respiratory failure who were at risk of death due to refusal of nasal ventilation or its failure despite ongoing treatment. We report their improvement with oral modafinil 200 mg tablets used as a respiratory stimulant, which led to discharge, improved arterial blood gases, and offset further admissions with hypercapnic respiratory failure. This drug is licensed for narcolepsy and is said to stimulate the respiratory system via the central nervous system. Its use in respiratory failure is an unlicensed indication, and there are no case reports or studies of such use in the literature. Its respiratory stimulant effects appear better than those with protriptyline, which was a drug previously used until its production was discontinued. Our findings suggest that a study of modafinil in hypercapnic respiratory failure would be warranted, especially for patients with treatment failure or intolerance to nasal ventilation. This may offer a way of shortening hospital stay, improving outcome and quality of life, and reducing death and readmissions. PMID:24812505

Parnell, Helen; Quirke, Ginny; Farmer, Sally; Adeyemo, Sumbo; Varney, Veronica

2014-01-01

25

Encrusted cystitis causing postrenal failure.  

PubMed

Encrusted cystitis is characterized by chronic inflammation of the bladder with encrustation of the mucosa, induced by urea-splitting bacterial infection. However, encrusted cystitis in itself is not well known. We report a case of encrusted cystitis causing postrenal failure. An 81-year-old man with pneumonia complained of pollakisuria, micturition pain, and gross hematuria. Bladder calculi were found, and transurethral lithotripsy was performed. However, because his symptoms did not improve, he was referred to our hospital. His urine pH was 8.5, and urine culture grew Corynebacterium and Proteus. Computerized tomography and cystoscopy revealed bladder "encrustation," caused by bladder wall calcification, and bilateral hydronephrosis. Hence, he was diagnosed with postrenal failure resulting from encrusted cystitis. Immediate bilateral nephrostomy was constructed, with continuous bladder perfusion with an acid solution for acidification of his urine, followed by intravenous administration of ceftriaxone. After 2 weeks of treatment, the calcification disappeared and his bladder mucosa was normalized. The postrenal failure also improved and thus the nephrostomy tubes were removed. Encrusted cystitis is curable by prompt treatment with acidification of urine. Therefore, precise diagnosis and therapy are critical. PMID:23605319

Tanaka, Takaki; Yamashita, Shinichi; Mitsuzuka, Koji; Yamada, Shigeyuki; Kaiho, Yasuhiro; Nakagawa, Haruo; Arai, Yoichi

2013-12-01

26

Acute respiratory distress caused by Neosartorya udagawae  

PubMed Central

We describe the first reported case of acute respiratory distress syndrome (ARDS) attributed to Neosartorya udagawae infection. This mold grew rapidly in cultures of multiple respiratory specimens from a previously healthy 43-year-old woman. Neosartorya spp. are a recently recognized cause of invasive disease in immunocompromised patients that can be mistaken for their sexual teleomorph, Aspergillus fumigatus. Because the cultures were sterile, phenotypic identification was not possible. DNA sequencing of ITS, calmodulin and ?-tubulin genes supported identification of Neosartorya udagawae. Our case is the first report of ARDS associated with Neosartorya sp. infection and defines a new clinical entity. PMID:25379388

Farrell, John J.; Kasper, Douglas J.; Taneja, Deepak; Baman, Sudhakar; O?Rourke, Lindsay M.; Lowery, Kristin S.; Sampath, Rangarajan; Bonomo, Robert A.; Peterson, Stephen W.

2014-01-01

27

Bronchoscopy with N-acetylcysteine lavage in severe respiratory failure from pertussis infection.  

PubMed

Pertussis is an illness that causes significant morbidity and mortality, especially in infants younger than 3 months old. In the most severe cases, it can cause pneumonia, respiratory failure, acute respiratory distress syndrome, pulmonary hypertension, and death. There are reports of using rescue extracorporeal membrane oxygenation (ECMO) as a rescue therapy. However, the mortality of ECMO with pertussis is higher than with other causes of pediatric respiratory failure. We report here the case of a 2-month-old boy with severe respiratory failure and pulmonary hypertension who satisfied ECMO criteria but was successfully treated with repeated bronchoscopy with instillation of N-acetylcysteine. Our patient's respiratory failure was refractory to multiple therapies that have shown benefit in pediatric hypoxemic respiratory failure, including open lung strategies, prone positioning, intratracheal surfactant, and inhaled nitric oxide. Although pulmonary hypertension is a key factor in most cases of fatal pertussis, the adverse effects of hyperinflation and air leaks were more important in this patient's clinical course. Because bronchiolar obstruction from inflammatory, mucous, and airway epithelial debris can be seen in severe pertussis, a regimen of repeated therapeutic bronchoscopy was initiated, and thick, inspissated secretions were retrieved. The patient's airway obstruction gradually resolved, and he eventually recovered with minimal sequelae. PMID:24167177

Mata, Angela F; Sarnaik, Ajit A

2013-11-01

28

MODELING CARDIOVASCULAR AND RESPIRATORY DYNAMICS IN CONGESTIVE HEART FAILURE  

E-print Network

pathophysiological links between sleep-related breathing disorders and cardiovascular diseases have recently receivedMODELING CARDIOVASCULAR AND RESPIRATORY DYNAMICS IN CONGESTIVE HEART FAILURE LAURA M. ELLWEIN1. This study develops a coupled cardiovascular-respiratory model that predicts cerebral blood flow velocity

Olufsen, Mette Sofie

29

Large thymolipoma causing primarily respiratory distress.  

PubMed

Thymolipoma, is an anterior mediastinal tumor that is benign in origin. It is often asymptomatic, but can enlarge significantly prior to diagnosis. It consists of thymic and fatty tissue and is surrounded by a capsule. Less than a hundred cases have been reported worldwide. Although rare, it should be considered in the differential diagnosis of mediastinal tumors. In this paper, we report the case of a 44-year-old woman presenting with a giant thymolipoma causing symptoms of severe respiratory distress. The patient underwent surgical resection, which is the main treatment, and remains free of disease. PMID:22919867

Abi Ghanem, Moussa; Habambo, Georges; Bahous, Joudy; Chouairy, Camil; Abu Khalil, Bassam

2012-01-01

30

Respiratory failure and sleep in neuromuscular disease  

Microsoft Academic Search

Sleep hypoxaemia in non-rapid eye movement (non-REM) and rapid eye movement (REM) sleep was examined in 20 patients with various neuromuscular disorders with reference to the relation between oxygen desaturation during sleep and daytime lung and respiratory muscle function. All the patients had all night sleep studies performed and maximum inspiratory and expiratory mouth pressures (PI and Pemax), lung volumes,

P T Bye; E R Ellis; F G Issa; P M Donnelly; C E Sullivan

1990-01-01

31

Gene therapy: a novel way to treat respiratory failure?  

PubMed

Respiratory failure leads to tissue hypoxia and subsequent organ damage. The crocodile hemoglobin affinity for oxygen is significantly reduced in the presence of CO2, allowing crocodiles to stay under water for more than 1h. The crocodile bicarbonate effect can possibly be transplanted into the human hemoglobin by replacing only five and seven amino acid residues in the ?-globin and ?-globin chains, respectively. The resulting hybrid formed by these modified chains has been named Scuba hemoglobin. The in vitro production of Scuba hemoglobin by human hematopoietic stem cells and their reintroduction into the blood could be an interesting tool to improve tissue oxygenation in patients suffering from respiratory failure. PMID:24679667

Kamoun, Pierre P

2014-06-01

32

Extracorporeal support for severe acute respiratory failure.  

PubMed

Extracorporeal membrane oxygenation (ECMO) and extracorporeal CO(2) removal (ECCO(2)R) techniques have increasingly been applied in patients with severe acute lung injury refractory to conventional mechanical ventilatory support. The objectives of this article are to review current concepts of extracorporeal life support techniques (ECMO and ECCO(2)R systems) and provide the rationale for their application in patients with acute respiratory distress syndrome, chronic obstruction pulmonary disease, and as adjunctive therapy for bridging patients to lung transplantation. PMID:25111648

Fanelli, V; Costamagna, A; Ranieri, V Marco

2014-08-01

33

Acute respiratory failure after endoscopic third ventriculostomy: A case report and review of the literature.  

PubMed

Endoscopic third ventriculostomy (ETV) is a relatively safe procedure. However, postoperative acute respiratory failure may be fatal. The authors report an 8-month-old patient with obstructive hydrocephalus secondary to posterior fossa cyst, and Chiari malformation. After ETV he developed difficulty in breathing, and had to be reintubated and ventilated. The infant recovered fully after craniocervical decompression and insertion of cystoperitoneal shunt. We speculate that respiratory failure is related to relative expansion of the posterior fossa arachnoid cyst, causing significant compression on the brain stem. Supportive care with mechanical ventilation and brain stem decompression were the mainstay of treatment. PMID:23493148

Elgamal, Essam A; Aqil, Mansoor

2012-01-01

34

Acute respiratory failure after endoscopic third ventriculostomy: A case report and review of the literature  

PubMed Central

Endoscopic third ventriculostomy (ETV) is a relatively safe procedure. However, postoperative acute respiratory failure may be fatal. The authors report an 8-month-old patient with obstructive hydrocephalus secondary to posterior fossa cyst, and Chiari malformation. After ETV he developed difficulty in breathing, and had to be reintubated and ventilated. The infant recovered fully after craniocervical decompression and insertion of cystoperitoneal shunt. We speculate that respiratory failure is related to relative expansion of the posterior fossa arachnoid cyst, causing significant compression on the brain stem. Supportive care with mechanical ventilation and brain stem decompression were the mainstay of treatment. PMID:23493148

Elgamal, Essam A.; Aqil, Mansoor

2012-01-01

35

[Transient acute respiratory failure and thoracic epidural anesthesia].  

PubMed

A case is reported of acute respiratory failure occurring during upper abdominal surgery in a patient not previously known to have chronic respiratory failure. Preoperatively, this 68 year old patient presented with mild obesity, slight effort dyspnoea and paralysis of the right hemidiaphragm, a sequela of polytrauma she suffered the year before. Respiratory tests were not considered useful with regard to the results of clinical examination. Moreover, she had already several previous general anaesthetics without any problems. A thoracic epidural anaesthesia was performed with a mixture of 150 mg lidocaine, 37.5 mg bupivacaine with adrenaline and 100 micrograms fentanyl, injected in the T8-T9 epidural space via a catheter. Ten minutes after the starting of surgery, the patient became agitated and complained of difficulty in breathing. Blood gas analysis showed hypercapnia, with respiratory acidosis (Pao2: 28.19 kPa; Paco2: 9.2 kPa; pH 7.273). Clinical examination revealed a bilateral Horner syndrome (T1-T4 sympathetic blockade). The patient was intubated and ventilated after adequate sedation. She was extubated 3 h 30 min after the initial epidural injection. Epidural analgesia was maintained during 72 h, with 0.1% bupivacaine, with no recurrence of respiratory failure. PMID:2735573

Maries, H; Joyau, F H

1989-01-01

36

Unsuspected 34-week pregnancy presenting as acute hypoxaemic respiratory failure  

Microsoft Academic Search

An obese body habitus may interfere with diagnosis of potentially life-threatening conditions. This report describes an obese woman who presented with acute hypoxemic respiratory failure and diffuse infiltrates. Her body habitus disguised her parturient abdomen and she could not provide a history because she was intubated and paralysed. Only after a urine pregnancy test was undertaken did it become apparent

Andrew M Luks

2007-01-01

37

Respirator management of sepsis-related respiratory failure  

Microsoft Academic Search

The first description of acute respiratory distress syndrome (ARDS) in adults appeared in 1967 and was characterized by dyspnea,\\u000a hypoxemia, diffuse alveolar infiltrates, and reduced respiratory system compliance. ARDS and acute lung injury (ALI) syndrome\\u000a have no specific treatment, only supportive care: treating the underlying cause, when possible, and using mechanical ventilation.\\u000a Historically, mechanical ventilation applied normal\\/large tidal volumes and

Davide Chiumello; Massimo Cressoni

2009-01-01

38

Respiratory considerations in the patient with renal failure.  

PubMed

Lung and kidney function are intimately related in both health and disease. Respiratory changes help to mitigate the systemic effects of renal acid-base disturbances, and the reverse is also true, although renal compensation occurs more slowly than its respiratory counterpart. A large number of diseases affect both the lungs and the kidneys, presenting most often with alveolar hemorrhage and glomerulonephritis. Most of these conditions are uncommon or rare, although three of them--Wegener's granulomatosis, systemic lupus erythematosus, and Goodpasture's syndrome--are not infrequently encountered by respiratory care clinicians. Respiratory complications of chronic renal failure include pulmonary edema, fibrinous pleuritis, pulmonary calcification, and a predisposition to tuberculosis. Urinothorax is a rare entity associated with obstructive uropathy. Sleep disturbances are extremely common in patients with end-stage renal disease, with sleep apnea occurring in 60% or more of such patients. The management of patients with acute renal failure is frequently complicated by pulmonary edema and the effects of both fluid overload and metabolic acidosis. These processes affect the management of mechanical ventilation in such patients and may interfere with weaning. Successful lung-protective ventilation in patients with acute lung injury and renal failure may require modification of hemodialysis in order to combat severe acidemia. Hemodialysis-related hypoxemia, which was once believed to be the result of pulmonary leukostasis and complement activation, is explained by diffusion of CO2 into the dialysate, with concomitant alveolar hypoventilation in the process of maintaining a normal P(aCO2). Like acute lung injury, renal failure is a common complication of critical illness. An increasing body of evidence also supports the notion that the kidneys, like the lungs, are susceptible to injury induced as a result of positive-pressure mechanical ventilation. PMID:16563195

Pierson, David J

2006-04-01

39

Chronic sublethal stress causes bee colony failure.  

PubMed

Current bee population declines and colony failures are well documented yet poorly understood and no single factor has been identified as a leading cause. The evidence is equivocal and puzzling: for instance, many pathogens and parasites can be found in both failing and surviving colonies and field pesticide exposure is typically sublethal. Here, we investigate how these results can be due to sublethal stress impairing colony function. We mathematically modelled stress on individual bees which impairs colony function and found how positive density dependence can cause multiple dynamic outcomes: some colonies fail while others thrive. We then exposed bumblebee colonies to sublethal levels of a neonicotinoid pesticide. The dynamics of colony failure, which we observed, were most accurately described by our model. We argue that our model can explain the enigmatic aspects of bee colony failures, highlighting an important role for sublethal stress in colony declines. PMID:24112478

Bryden, John; Gill, Richard J; Mitton, Robert A A; Raine, Nigel E; Jansen, Vincent A A

2013-12-01

40

Chronic sublethal stress causes bee colony failure  

PubMed Central

Current bee population declines and colony failures are well documented yet poorly understood and no single factor has been identified as a leading cause. The evidence is equivocal and puzzling: for instance, many pathogens and parasites can be found in both failing and surviving colonies and field pesticide exposure is typically sublethal. Here, we investigate how these results can be due to sublethal stress impairing colony function. We mathematically modelled stress on individual bees which impairs colony function and found how positive density dependence can cause multiple dynamic outcomes: some colonies fail while others thrive. We then exposed bumblebee colonies to sublethal levels of a neonicotinoid pesticide. The dynamics of colony failure, which we observed, were most accurately described by our model. We argue that our model can explain the enigmatic aspects of bee colony failures, highlighting an important role for sublethal stress in colony declines. PMID:24112478

Bryden, John; Gill, Richard J; Mitton, Robert A A; Raine, Nigel E; Jansen, Vincent A A; Hodgson, David

2013-01-01

41

Pyrotechnic system failures: Causes and prevention  

NASA Technical Reports Server (NTRS)

Although pyrotechnics have successfully accomplished many critical mechanical spacecraft functions, such as ignition, severance, jettisoning and valving (excluding propulsion), failures continue to occur. Provided is a listing of 84 failures of pyrotechnic hardware with completed design over a 23-year period, compiled informally by experts from every NASA Center, as well as the Air Force Space Division and the Naval Surface Warfare Center. Analyses are presented as to when and where these failures occurred, their technical source or cause, followed by the reasons why and how these kinds of failures persist. The major contributor is a fundamental lack of understanding of the functional mechanisms of pyrotechnic devices and systems, followed by not recognizing pyrotechnics as an engineering technology, insufficient manpower with hands-on experience, too few test facilities, and inadequate guidelines and specifications for design, development, qualification and acceptance. Recommendations are made on both a managerial and technical basis to prevent failures, increase reliability, improve existing and future designs, and develop the technology to meet future requirements.

Bement, Laurence J.

1988-01-01

42

An unusual cause of respiratory distress in an infant.  

PubMed

Partial anomalous venous connection (PAPVC) is a congenital cardiovascular defect where one or more (but not all) of the pulmonary veins return anomalously back to the right atrium, either via a direct or indirect connection. It often occurs with other cardiac defects, most commonly a secundum atrial septal defect. Individuals with a large degree of shunting will present with dyspnea, fatigue, and, in some cases, heart failure. Clinical associations and variants of PAPVC include scimitar syndrome, pseudo-scimitar or meandering right pulmonary vein, sinous venosus defects, malposition of the septum primum, and Turner syndrome. The patient in this case, a previously healthy, 6-month-old, full-term male, presented to the emergency department for evaluation of respiratory distress and wheezing. The infant was first seen in his pediatrician's office, where he was noted to be tachypneic and wheezing. He was feeding without difficulty, voiding well, and was active and playful. The patient had passed critical congenital heart disease screening after his birth and prior to discharge, and the family history was negative for any respiratory or cardiac conditions. Cardiac magnetic resonance imaging is becoming the mode of choice for diagnosis of PAPVC. The definitive treatment is surgical correction, but surgery is not indicated in all cases, especially if the patient is asymptomatic and the degree of shunting is small. Patients with isolated PAPVC who undergo surgical correction have good long-term outcomes. In this case, the patient underwent the Warden procedure, which causes an increased risk of superior vena cava stenosis or obstruction to the right atrium. This patient will require lifelong follow-up to assess for new onset pulmonary venous obstruction. PMID:24877494

Rusciolelli, Colleen H; Hageman, Joseph R; Groner, Abraham

2014-05-01

43

Timing of noninvasive ventilation failure: causes, risk factors, and potential remedies  

PubMed Central

Background Identifying the predictors of noninvasive ventilation (NIV) failure has attracted significant interest because of the strong link between failure and poor outcomes. However, very little attention has been paid to the timing of the failure. This narrative review focuses on the causes of NIV failure and risk factors and potential remedies for NIV failure, based on the timing factor. Results The possible causes of immediate failure (within minutes to <1 h) are a weak cough reflex, excessive secretions, hypercapnic encephalopathy, intolerance, agitation, and patient-ventilator asynchrony. The major potential interventions include chest physiotherapeutic techniques, early fiberoptic bronchoscopy, changing ventilator settings, and judicious sedation. The risk factors for early failure (within 1 to 48 h) may differ for hypercapnic and hypoxemic respiratory failure. However, most cases of early failure are due to poor arterial blood gas (ABGs) and an inability to promptly correct them, increased severity of illness, and the persistence of a high respiratory rate. Despite a satisfactory initial response, late failure (48 h after NIV) can occur and may be related to sleep disturbance. Conclusions Every clinician dealing with NIV should be aware of these risk factors and the predicted parameters of NIV failure that may change during the application of NIV. Close monitoring is required to detect early and late signs of deterioration, thereby preventing unavoidable delays in intubation. PMID:24520952

2014-01-01

44

Titin mutation segregates with hereditary myopathy with early respiratory failure  

PubMed Central

In 2001, we described an autosomal dominant myopathy characterized by neuromuscular ventilatory failure in ambulant patients. Here we describe the underlying genetic basis for the disorder, and we define the neuromuscular, respiratory and radiological phenotype in a study of 31 mutation carriers followed for up to 31 years. A combination of genome-wide linkage and whole exome sequencing revealed the likely causal genetic variant in the titin (TTN) gene (g.274375T>C; p.Cys30071Arg) within a shared haplotype of 2.93 Mbp on chromosome 2. This segregated with the phenotype in 21 individuals from the original family, nine subjects in a second family with the same highly selective pattern of muscle involvement on magnetic resonance imaging and a third familial case with a similar phenotype. Comparing the mutation carriers revealed novel features not apparent in our original report. The clinical presentation included predominant distal, proximal or respiratory muscle weakness. The age of onset was highly variable, from early adulthood, and including a mild phenotype in advanced age. Muscle weakness was earlier onset and more severe in the lower extremities in nearly all patients. Seven patients also had axial muscle weakness. Respiratory function studies demonstrated a gradual deterioration over time, reflecting the progressive nature of this condition. Cardiomyopathy was not present in any of our patients despite up to 31 years of follow-up. Magnetic resonance muscle imaging was performed in 21 affected patients and revealed characteristic abnormalities with semitendinosus involvement in 20 of 21 patients studied, including 3 patients who were presymptomatic. Diagnostic muscle histopathology most frequently revealed eosinophilic inclusions (inclusion bodies) and rimmed vacuoles, but was non-specific in a minority of patients. These findings have important clinical implications. This disease should be considered in patients with adult-onset proximal or distal myopathy and early respiratory failure, even in the presence of non-specific muscle pathology. Muscle magnetic resonance imaging findings are characteristic and should be considered as an initial investigation, and if positive should prompt screening for mutations in TTN. With 363 exons, screening TTN presented a major challenge until recently. However, whole exome sequencing provides a reliable cost-effective approach, providing the gene of interest is adequately captured. PMID:22577215

Pfeffer, Gerald; Elliott, Hannah R.; Griffin, Helen; Barresi, Rita; Miller, James; Marsh, Julie; Evilä, Anni; Vihola, Anna; Hackman, Peter; Straub, Volker; Dick, David J.; Horvath, Rita; Santibanez-Koref, Mauro; Udd, Bjarne

2012-01-01

45

Acute Respiratory Failure in Patients with Severe Community-acquired Pneumonia A Prospective Randomized Evaluation of Noninvasive Ventilation  

Microsoft Academic Search

In uncontrolled studies, noninvasive positive pressure ventilation (NPPV) was found useful in avoid- ing endotracheal intubation in patients with acute respiratory failure (ARF) caused by severe commu- nity-acquired pneumonia (CAP). We conducted a prospective, randomized study comparing stan- dard treatment plus NPPV delivered through a face mask to standard treatment alone in patients with severe CAP and ARF. Patients fitting

MARCO CONFALONIERI; ALFREDO POTENA; GIORGIO CARBONE; ROSSANA DELLA PORTA; ELIZABETH A. TOLLEY; G. UMBERTO MEDURI

46

Coronavirus as a possible cause of severe acute respiratory syndrome  

Microsoft Academic Search

Summary Background An outbreak of severe acute respiratory syndrome (SARS) has been reported in Hong Kong. We investigated the viral cause and clinical presentation among 50 patients. Methods We analysed case notes and microbiological findings for 50 patients with SARS, representing more than five separate epidemiologically linked transmission clusters. We defined the clinical presentation and risk factors associated with severe

JSM Peiris; ST Lai; LLM Poon; Y Guan; LYC Yam; W Lim; J Nicholls; WKS Yee; WW Yan; MT Cheung; VCC Cheng; KH Chan; DNC Tsang; RWH Yung; TK Ng; KY Yuen

2003-01-01

47

Clinical review: Respiratory failure in HIV-infected patients - a changing picture  

PubMed Central

Respiratory failure in HIV-infected patients is a relatively common presentation to ICU. The debate on ICU treatment of HIV-infected patients goes on despite an overall decline in mortality amongst these patients since the AIDS epidemic. Many intensive care physicians feel that ICU treatment of critically ill HIV patients is likely to be futile. This is mainly due to the unfavourable outcome of HIV patients with Pneumocystis jirovecii pneumonia who need mechanical ventilation. However, the changing spectrum of respiratory illness in HIV-infected patients and improved outcome from critical illness remain under-recognised. Also, the awareness of certain factors that can affect their outcome remains low. As there are important ethical and practical implications for intensive care clinicians while making decisions to provide ICU support to HIV-infected patients, a review of literature was undertaken. It is notable that the respiratory illnesses that are not directly related to underlying HIV disease are now commonly encountered in the highly active antiretroviral therapy (HAART) era. The overall incidence of P. jirovecii as a cause of respiratory failure has declined since the AIDS epidemic and sepsis including bacterial pneumonia has emerged as a frequent cause of hospital and ICU admission amongst HIV patients. The improved overall outcome of HIV patients needing ICU admission is related to advancement in general ICU care, including adoption of improved ventilation strategies. An awareness of respiratory illnesses in HIV-infected patients along with an appropriate diagnostic and treatment strategy may obviate the need for invasive ventilation and improve outcome further. HIV-infected patients presenting with respiratory failure will benefit from early admission to critical care for treatment and support. There is evidence to suggest that continuing or starting HAART in critically ill HIV patients is beneficial and hence should be considered after multidisciplinary discussion. As a very high percentage (up to 40%) of HIV patients are not known to be HIV infected at the time of ICU admission, the clinicians should keep a low threshold for requesting HIV testing for patients with recurrent pneumonia. PMID:23806117

2013-01-01

48

[Four cases of respiratory tract infections caused by Corynebacterium pseudodiphtheriticum].  

PubMed

Four cases of respiratory tract infections caused by Corynebacterium pseudodiphtheriticum were reported. The first two patients developed pneumonia with Corynebacterium pseudodiphtheriticum during steroid therapy used against their underlying diseases. The other two patients had acute exacerbation of chronic pulmonary diseases caused by C. pseudodiphtheriticum. These four patients improved by antibiotic therapy. Though nondiphtheria corynebacteria are regarded as "normal flora" when they are isolated from sputum, they should be recognized as potential pathogens. PMID:1402067

Yoshitomi, Y; Higashiyama, Y; Matsuda, H; Mitsutake, K; Miyazaki, Y; Maesaki, S; Yamada, H; Hori, H; Koga, H; Kohno, S

1992-01-01

49

Respiratory failure in a patient with antecedent poliomyelitis: amyotrophic lateral sclerosis or post-polio syndrome?  

PubMed

We report a 69-year-old man who developed paralytic poliomyelitis in childhood and then decades later suffered from fatal respiratory failure. Six months before this event, he had progressive weight loss and shortness of breath. He had severe muscular atrophy of the entire right leg as a sequela of the paralytic poliomyelitis. He showed mild weakness of the facial muscle and tongue, dysarthria, and severe muscle atrophy from the neck to proximal upper extremities and trunk, but no obvious pyramidal signs. Electromyogram revealed neurogenic changes in the right leg, and in the paraspinal, sternocleidomastoid, and lingual muscles. There was a slight increase in central motor conduction time from the motor cortex to the lumbar anterior horn. Pulmonary function showed restrictive ventilation dysfunction, which was the eventual cause of death. Some neuropathological features were suggestive of amyotrophic lateral sclerosis (ALS), namely Bunina bodies. In patients with a history of paralytic poliomyelitis who present after a long stable period with advanced fatal respiratory failure, one may consider not only respiratory impairment from post-polio syndrome but also the onset of ALS. PMID:16165267

Terao, Shin-ichi; Miura, Naofumi; Noda, Aiji; Yoshida, Mari; Hashizume, Yoshio; Ikeda, Hiroshi; Sobue, Gen

2006-10-01

50

Failure cause analysis: fans. Final report  

SciTech Connect

Surveys by the Edison Electric Institute have identified power plant fans to be a significant cause of plant failures. This report contains the results of a study to identify fan problem areas, their causes and their effects. A data base of 743 fans was prepared from questionnaires distributed to US utilities and to the Tennessee Valley Authority. Additional information was obtained from personal contacts with various power company personnel, station records and reports, and EPRI files. The great majority of fans studied were centrifugal units used in forced draft, induced draft, primary air, and gas recirculating applications. As controllable-pitch axial fans have seen service only recently in the United States, the number of such fans available for study is relatively small. Data analysis resulting clearly demonstrates problems with draft fan systems and their components which contribute to the unavailability of generating units. Seventeen specific problem components are identified for centrifugal fans; bearings, blades, and foundations account for more than 54% of the centrifugal fan problems. Nine specific problem components are identified in the case of axial fans; blade, shaft bearings, and blade thrust bearings account for over 52% of the axial fan problems. The indicated causes and effects are documented. Recommendations are made to improve the reliability of existing fans, and generic problems requiring future research and application of existing technologies are identified. It is also recommended that users place less emphasis on the initial costs of fans and more emphasis on those design features that improve reliability to encourage manufacturers to accelerate their efforts to improve the technology and correct critical problems. Implementation of the recommendations could substantially improve the availability of fans.

Wood, C.O.

1981-02-01

51

Non-invasive ventilation with bubble CPAP is feasible and improves respiratory physiology in hospitalised Malawian children with acute respiratory failure.  

PubMed

Background: In low-income countries and those with a high prevalence of HIV, respiratory failure is a common cause of death in children. However, the role of non-invasive ventilation with bubble continuous positive airway pressure (bCPAP) in these patients is not well established. Methods: A prospective observational study of bCPAP was undertaken between July and September 2012 in 77 Malawian children aged 1 week to 14 years with progressive acute respiratory failure despite oxygen and antimicrobial therapy. Results: Forty-one (53%) patients survived following bCPAP treatment, and an HIV-uninfected single-organ disease subgroup demonstrated bCPAP success in 14 of 17 (82%). Compared with children aged ?60 months, infants of 0-2 months had a 93% lower odds of bCPAP failure (odds ratio 0·07, 95% confidence interval 0·004-1·02, P ?=? 0·05). Following commencement of bCPAP, respiratory physiology improved, the average respiratory rate decreased from 61 to 49 breaths/minute (P ?=? 0·0006), and mean oxygen saturation increased from 92·1% to 96·1% (P ?=? 0·02). Conclusions: bCPAP was well accepted by caregivers and patients and can be feasibly implemented into a tertiary African hospital with high-risk patients and limited resources. PMID:25434361

Walk, J; Dinga, P; Banda, C; Msiska, T; Chitsamba, E; Chiwayula, N; Lufesi, N; Mlotha-Mitole, R; Costello, A; Phiri, A; Colbourn, T; McCollum, E D; Lang, H J

2014-11-30

52

[Acute renal failure caused by phenazopyridine].  

PubMed

A 27 years old woman was admitted due to abdominal cramps, jaundice and oligoanuria, starting 48 hours after eating Chinese food. Hepatic biochemical tests, abdominal ultrasound and retrograde pyelography were normal. The urine was intensely orange colored and microscopic analysis was normal. The serum creatinine and urea nitrogen on admission were 4.59 and 42.5 mg/dl and rose to 13.5 and 72.4 mg/dl, respectively, at the 6th hospital day. Oliguria lasted only 48 hours. Dialysis was not used, since the patient was in good general condition and uremic symptoms were absent. On the 7th day, azotemia began to subside and at the 14th day, serum creatinine was 1.0 mg/dl. Before hospital discharge, she confessed the ingestion of 2.000 mg of phenazopyridine, during a nervous breakdown, aiming to sleep deeply. Remarkable was the persistence of the orange color of her urine during several days and the dissociation between the rate of increase of serum creatinine with respect to urea nitrogen. This is an unusual case of acute renal failure caused by an overdose of a drug, commonly prescribed for urinary tract infections. PMID:12879816

Vega, Jorge

2003-05-01

53

Efficacy of Veno-Venous Extracorporeal Membrane Oxygenation in Severe Acute Respiratory Failure  

PubMed Central

Purpose The objective of this study was to evaluate our institutional experience with veno-venous (VV) extracorporeal membrane oxygenation (ECMO) in patients with severe acute respiratory failure (ARF). Materials and Methods From January 2007 to August 2013, 31 patients with severe ARF that was due to various causes and refractory to mechanical ventilation with conventional therapy were supported with VV ECMO. A partial pressure of arterial oxygen (PaO2)/inspired fraction of oxygen (FiO2) <100 mm Hg at an FiO2 of 1.0 or a pH <7.25 due to CO2 retention were set as criteria for VV ECMO. Results Overall, 68% of patients survived among those who had received VV ECMO with a mean PaO2/FiO2 of 56.8 mm Hg. Furthermore, in trauma patients, early use of ECMO had the best outcome with a 94% survival rate. Conclusion VV ECMO is an excellent, life-saving treatment option in patients suffering from acute and life-threatening respiratory failure due to various causes, especially trauma, and early use of VV ECMO therapy improved outcomes in these patients. PMID:25510767

Lee, Jae Jun; Hwang, Sung Mi; Ko, Jae Houn; Hong, Kyung Soon; Choi, Hyun Hee; Lee, Myung Goo; Lee, Chang Youl; Lee, Won Ki; Soun, Eun Jin; Lee, Tae Hun; Seo, Jeong Yeol

2015-01-01

54

Postmortem diagnosis of acute myocardial infarction in patients with acute respiratory failure - demographics, etiologic and pulmonary histologic analysis  

PubMed Central

OBJECTIVES: Acute respiratory failure is present in 5% of patients with acute myocardial infarction and is responsible for 20% to 30% of the fatal post-acute myocardial infarction. The role of inflammation associated with pulmonary edema as a cause of acute respiratory failure post-acute myocardial infarction remains to be determined. We aimed to describe the demographics, etiologic data and histological pulmonary findings obtained through autopsies of patients who died during the period from 1990 to 2008 due to acute respiratory failure with no diagnosis of acute myocardial infarction during life. METHODS: This study considers 4,223 autopsies of patients who died of acute respiratory failure that was not preceded by any particular diagnosis while they were alive. The diagnosis of acute myocardial infarction was given in 218 (4.63%) patients. The age, sex and major associated diseases were recorded for each patient. Pulmonary histopathology was categorized as follows: diffuse alveolar damage, pulmonary edema, alveolar hemorrhage and lymphoplasmacytic interstitial pneumonia. The odds ratio of acute myocardial infarction associated with specific histopathology was determined by logistic regression. RESULTS: In total, 147 men were included in the study. The mean age at the time of death was 64 years. Pulmonary histopathology revealed pulmonary edema as well as the presence of diffuse alveolar damage in 72.9% of patients. Bacterial bronchopneumonia was present in 11.9% of patients, systemic arterial hypertension in 10.1% and dilated cardiomyopathy in 6.9%. A multivariate analysis demonstrated a significant positive association between acute myocardial infarction with diffuse alveolar damage and pulmonary edema. CONCLUSIONS: For the first time, we demonstrated that in autopsies of patients with acute respiratory failure as the cause of death, 5% were diagnosed with acute myocardial infarction. Pulmonary histology revealed a significant inflammatory response, which has not previously been reported. PMID:22473400

de Matos Soeiro, Alexandre; Ruppert, Aline D; Canzian, Mauro; Capelozzi, Vera L; Serrano, Carlos V

2012-01-01

55

Efficacy of noninvasive volume targeted ventilation in patients with chronic respiratory failure due to kyphoscoliosis.  

PubMed

Severe kyphoscoliosis can cause chronic respiratory failure. Noninvasive mechanical ventilation (NIMV) is a new optional treatment for such patients. The aim of this study was to evaluate the effectiveness of average volume-assured pressure support (AVAPS) NIMV in patients with kyphoscoliotic chronic respiratory failure. The study was performed in 12 patients (mean age 49?±?11 years and body mass index 27.5?±?7.9 kg/m(2)) with advanced kyphoscoliosis complicated by severe respiratory failure (PaO2 6.68?±?0.34 kPa, SaO2 81.7?±?3.1 %, PaCO2 9.51?±?1.08 kPa) treated by the NIMV. The short-term, after 5 days, and long-term, after 1 year of home treatment, efficacy of NIMV was evaluated. We found a significant improvement of diurnal PaO2 and PaCO2 on the 5th day of NIMV (an increase of 1.4?±?0.3 kPa and a decrease of 1.8?±?0.8 kPa, respectively; p?respiratory failure, resulting in a prompt and long-term improvement of daytime and nocturnal blood gas exchange. PMID:25315620

Piesiak, P; Brzecka, A; Kosacka, M; Jankowska, R

2015-01-01

56

Respiratory failure associated with hypoventilation in a patient with severe hypothyroidism  

PubMed Central

A 70-year-old Japanese man was admitted to hospital because of decreased consciousness due to type II respiratory failure. Severe hypothyroidism was diagnosed and considered to be associated with hypoventilation due to respiratory muscle dysfunction and sleep apnea syndrome. His status was improved partially by replacement of thyroid hormone. Despite maintaining a euthyroid state, improvement of respiratory muscle dysfunction was incomplete. PMID:25473574

Fukusumi, Munehisa; Iidaka, Toshiko; Mouri, Atsuto; Hamamoto, Yoichiro; Kamimura, Mitsuhiro

2014-01-01

57

Electrical impedance tomography may optimize ventilation in a postpartum woman with respiratory failure.  

PubMed

Amniotic fluid embolism is a rare peripartum complication with the sudden onset of haemodynamic instability, respiratory failure and coagulopathy during labour or soon after delivery. A 31-year-old woman with amniotic fluid embolism was treated with vasopressors, inotropes, intravenous fluid, tranexamic acid and ventilatory support. Assessment of respiratory impairment was made using conventional chest X-ray, computed tomography and electrical impedance tomography. The potential for electrical impedance tomography to improve monitoring and guide respiratory therapy is explored. PMID:23122281

Karsten, J; Bohlmann, M K; Sedemund-Adib, B; Wnent, J; Paarmann, H; Iblher, P; Meier, T; Heinze, H

2013-01-01

58

Emergency escape surgery for a gastro-bronchial fistula with respiratory failure that developed after esophagectomy.  

PubMed

A gastro-bronchial fistula (GBF) is a rare complication after esophageal reconstruction using a gastric tube, but it can cause severe pneumonia, and the surgical procedure is challenging. We herein describe a patient who was successfully managed using a two-stage operation for a GBF. Because the patient had life-threatening pneumonia and respiratory failure caused by the GBF, we first transected the duodenum, established a cervical esophagostomy and gastrostomy and placed a decompression catheter in the gastric tube without a thoracotomy. The patient recovered from pneumonia after the resolution of the salivary inflow and digestive juice reflux into the lungs through the GBF. Two months later, an esophageal bypass was achieved by reconstructing the esophagus using a long segment of pedicled jejunum. The patient was discharged 38 days thereafter. Appropriate treatment for GBF should be tailored to individual patients based on their current status and disease severity. PMID:24449022

Ibuki, Yuta; Hamai, Yoichi; Hihara, Jun; Taomoto, Junya; Kishimoto, Ichiko; Miyata, Yoshihiro; Okada, Morihito

2015-03-01

59

Amyotrophic Lateral Sclerosis Presenting Respiratory Failure as the Sole Initial Manifestation  

PubMed Central

It is rare that amyotrophic lateral sclerosis (ALS) presents with respiratory failure as the sole initial manifestation. A 72-year-old man with mild chronic obstructive pulmonary disease developed exertional dyspnea for 13 months. He then progressed to limb weakness that led to the diagnosis of ALS. Although rare, ALS can present with respiratory failure as the sole initial manifestation more than 1 year prior to limb weakness. PMID:25232334

Tateno, Fuyuki; Sakakibara, Ryuji; Kawashima, Kengo; Kishi, Masahiko; Tsuyusaki, Yohei; Aiba, Yosuke; Ogata, Tsuyoshi

2014-01-01

60

Telemedicine system for the care of patients with neuromuscular disease and chronic respiratory failure  

PubMed Central

Introduction Neuromuscular diseases cause a number of limitations which may be improved by using a telemedicine system. These include functional impairment and dependence associated with muscle weakness, the insidious development of respiratory failure and episodes of exacerbation. Material and methods The present study involved three patients with severe neuromuscular disease, chronic respiratory failure and long-term mechanical ventilation, who were followed up using a telemedicine platform. The telemedicine system is based on videoconferencing and telemonitoring of cardiorespiratory variables (oxygen saturation, heart rate, blood pressure and electrocardiogram). Two different protocols were followed depending on whether the patient condition was stable or unstable. Results Over a period of 5 years, we analyzed a series of variables including use of the system, patient satisfaction and clinical impact. Overall we performed 290 videoconference sessions, 269 short monitoring oximetry measurements and 110 blood pressure measurements. With respect to the clinical impact, after enrolment in the telemedicine program, the total number of hospital admissions fell from 18 to 3. Conclusions Our findings indicate that the system was user friendly for patients and care givers. Patient satisfaction scores were acceptable. The telemedicine system was effective for the home treatment of three patients with severe neuromuscular diseases and reduced the need for hospital admissions. PMID:25395959

Morete, Emilio; González, Francisco

2014-01-01

61

Respiratory muscle function and exercise intolerance in heart failure.  

PubMed

Inspiratory muscle weakness (IMW) is prevalent in patients with chronic heart failure (CHF) caused by left ventricular systolic dysfunction, which contributes to reduced exercise capacity and the presence of dyspnea during daily activities. Inspiratory muscle strength (estimated by maximal inspiratory pressure) has independent prognostic value in CHF. Overall, the results of trials with inspiratory muscle training (IMT) indicate that this intervention improves exercise capacity and quality of life, particularly in patients with CHF and IMW. Some benefit from IMT may be accounted for by the attenuation of the inspiratory muscle metaboreflex. Moreover, IMT results in improved cardiovascular responses to exercise and to those obtained with standard aerobic training. These findings suggest that routine screening for IMW is advisable in patients with CHF, and specific IMT and/or aerobic training are of practical value in the management of these patients. PMID:19486593

Ribeiro, Jorge P; Chiappa, Gaspar R; Neder, J Alberto; Frankenstein, Lutz

2009-06-01

62

Common environmental allergens causing respiratory allergy in India.  

PubMed

Respiratory allergy affects all age groups but the children are the worst affected by the respiratory allergy. Bioparticles from different biological sources are the main cause of allergy. Pollen grains, fungal spores, insect and other materials of biological origin form the most important allergen load in the air. For the efficient diagnosis of the allergy and its effective treatment it is very important to know about the prevalence, seasonal and annual variations of aeroallergens of the area. India being the climatically diversed country, there is diversity in the flora and fauna of different parts of the country. Atmospheric surveys carried out in different parts of India reveal that, Alanus nitida, Amarantus spinosus, Argemone mexicana Cocos nucifera, Betula utilis, Borasus flabellifer, Caraica papaya, Cedrus deodara, Cassia fistula, Parthenium, Chenopodium album, Dodonaea viscosa, Malotus phillipensis, Plantago ovata, Prosopis juliflora, Ricinus communis, Holoptelea intergifolia are the allergenically important pollens of the country. Among the fungal aeroallergens, Alternaria, Candida aibieans, Aspergillus versicolor, Aspergillus terreus, Aspergillus japonicus, Cladosporium cladosporoides, Fusarium roseum, Ganoderma lucidum,Neurospora sitophila Helminthosporium, Ustilago trtici, Uromyses are important allergens. Dust mites D. farinae, D.pteronyssinus are also important source of inhalant allergens particularly in the coastal areas of the country. Cockroaches, beetles, weevils, mosquitoes, house flies also contribute towards the aeroallergen load and are allergenically implicated. Avoidance of the indoor and outdoor aeroallergens is recommended for better management of respiratory allergy. PMID:12003301

Singh, A B; Kumar, Pawan

2002-03-01

63

Common-Cause Failure Analysis in Event Assessment  

SciTech Connect

This paper describes the approach taken by the U. S. Nuclear Regulatory Commission to the treatment of common-cause failure in probabilistic risk assessment of operational events. The approach is based upon the Basic Parameter Model for common-cause failure, and examples are illustrated using the alpha-factor parameterization, the approach adopted by the NRC in their Standardized Plant Analysis Risk (SPAR) models. The cases of a failed component (with and without shared common-cause failure potential) and a component being unavailable due to preventive maintenance or testing are addressed. The treatment of two related failure modes (e.g., failure to start and failure to run) is a new feature of this paper. These methods are being applied by the NRC in assessing the risk significance of operational events for the Significance Determination Process (SDP) and the Accident Sequence Precursor (ASP) program.

Dana L. Kelly; Dale M. Rasmuson

2008-09-01

64

Reversal of respiratory failure in both neonatal and late onset isolated remethylation disorders.  

PubMed

Respiratory failure is a well-documented potential presentation of inherited isolated remethylation disorders (IRDs). It appears to be a combination of both central and peripheral neuropathy and has previously often been considered to herald an irreversible neurological decline. We present three patients, one with methionine synthase (cblG) and two with methyltetrahydrofolate reductase deficiency (MTHFR). One patient with MTHFR presented in infancy, and other patients in later childhood. All three patients required intubation for respiratory failure but in all three, this was totally reversed by the initiation of medical therapy. This consisted of betaine and folinic acid supplementation in all three, methionine in two and cobalamin supplementation in two. The rate of respiratory improvement was variable, though two of the cases were successful extubated within a week of commencement of medical therapy. We document their subsequent clinical, biochemical and electrophysiological progress and review the potential pathological mechanisms underlying respiratory failure in these disorders. PMID:24997712

Broomfield, A; Abulhoul, L; Pitt, W; Jameson, E; Cleary, M

2014-01-01

65

Intravascular foscarnet crystal precipitation causing multiorgan failure.  

PubMed

We report a case of multiorgan failure resulting from treatment with the antiviral foscarnet in a kidney transplant recipient. Precipitation of foscarnet crystals was confirmed histologically from a biopsy of the transplant using optical and infrared microscopy. In addition to kidney damage resulting from foscarnet crystal precipitation in the tubular lumen and glomerular capillaries, the patient presented with pancreatitis, pancolitis, and myocarditis with shock. Interruption of the treatment led to rapid improvement in her general condition, but did not prevent permanent loss of the kidney transplant. When faced with unexplained multiorgan failure in a patient treated with foscarnet, one should assume this substance to be toxic. A kidney biopsy can confirm this diagnosis. PMID:25301103

Philipponnet, Carole; Michel, Pierre-Antoine; Daudon, Michel; Brocheriou, Isabelle; Boffa, Jean-Jacques

2015-01-01

66

Acute respiratory distress syndrome and acute renal failure from Plasmodium ovale infection with fatal outcome  

PubMed Central

Background Plasmodium ovale is one of the causative agents of human malaria. Plasmodium ovale infection has long been thought to be non-fatal. Due to its lower morbidity, P. ovale receives little attention in malaria research. Methods Two Malaysians went to Nigeria for two weeks. After returning to Malaysia, they fell sick and were admitted to different hospitals. Plasmodium ovale parasites were identified from blood smears of these patients. The species identification was further confirmed with nested PCR. One of them was successfully treated with no incident of relapse within 12-month medical follow-up. The other patient came down with malaria-induced respiratory complication during the course of treatment. Although parasites were cleared off the circulation, the patient’s condition worsened. He succumbed to multiple complications including acute respiratory distress syndrome and acute renal failure. Results Sequencing of the malaria parasite DNA from both cases, followed by multiple sequence alignment and phylogenetic tree construction suggested that the causative agent for both malaria cases was P. ovale curtisi. Discussion In this report, the differences between both cases were discussed, and the potential capability of P. ovale in causing severe complications and death as seen in this case report was highlighted. Conclusion Plasmodium ovale is potentially capable of causing severe complications, if not death. Complete travel and clinical history of malaria patient are vital for successful diagnoses and treatment. Monitoring of respiratory and renal function of malaria patients, regardless of the species of malaria parasites involved is crucial during the course of hospital admission. PMID:24180319

2013-01-01

67

Human Respiratory Syncytial Virus Memphis 37 Causes Acute Respiratory Disease in Perinatal Lamb Lung  

PubMed Central

Abstract Respiratory syncytial virus (RSV) is the leading cause of hospitalization due to respiratory illness among infants and young children of industrialized countries. There is a lack of understanding of the severe disease mechanisms as well as limited treatment options, none of which are fully satisfactory. This is partly due to lack of a relevant animal model of perinatal RSV infection that mimics moderate to severe disease in infants. We and others have shown mild disease in perinatal lambs with either a bovine or a human A2 strain of RSV. The Memphis 37 clinical strain of human RSV has been used to produce mild to moderate upper respiratory disease in healthy adult volunteers. We hypothesized that the Memphis 37 strain of RSV would infect perinatal lambs and produce clinical disease similar to that in human infants. Perinatal (3- to 5-day-old) lambs were inoculated intranasally with 2?mL/nostril of 1×105 focus-forming units (FFU)/mL (n=2) or 2.1×108 FFU/mL (n=3) of RSV Memphis 37. Clinical signs, gross and histological lesions, and immune and inflammatory responses were assessed. Memphis 37 caused moderate to severe gross and histologic lesions along with increased mRNA expression of macrophage inflammatory protein. Clinically, four of the five infected lambs had a mild to severe increase in expiratory effort. Intranasally administered RSV strain Memphis 37 infects neonatal lambs with gross, histologic, and immune responses similar to those observed in human infants. PMID:24804166

van Geelen, Albert; Gallup, Jack M.; Kienzle, Thomas; Shelly, Daniel A.; Cihlar, Tomas; King, Robert R.; Ackermann, Mark R.

2014-01-01

68

Human respiratory syncytial virus memphis 37 causes acute respiratory disease in perinatal lamb lung.  

PubMed

Respiratory syncytial virus (RSV) is the leading cause of hospitalization due to respiratory illness among infants and young children of industrialized countries. There is a lack of understanding of the severe disease mechanisms as well as limited treatment options, none of which are fully satisfactory. This is partly due to lack of a relevant animal model of perinatal RSV infection that mimics moderate to severe disease in infants. We and others have shown mild disease in perinatal lambs with either a bovine or a human A2 strain of RSV. The Memphis 37 clinical strain of human RSV has been used to produce mild to moderate upper respiratory disease in healthy adult volunteers. We hypothesized that the Memphis 37 strain of RSV would infect perinatal lambs and produce clinical disease similar to that in human infants. Perinatal (3- to 5-day-old) lambs were inoculated intranasally with 2?mL/nostril of 1×10(5) focus-forming units (FFU)/mL (n=2) or 2.1×10(8) FFU/mL (n=3) of RSV Memphis 37. Clinical signs, gross and histological lesions, and immune and inflammatory responses were assessed. Memphis 37 caused moderate to severe gross and histologic lesions along with increased mRNA expression of macrophage inflammatory protein. Clinically, four of the five infected lambs had a mild to severe increase in expiratory effort. Intranasally administered RSV strain Memphis 37 infects neonatal lambs with gross, histologic, and immune responses similar to those observed in human infants. PMID:24804166

Derscheid, Rachel J; van Geelen, Albert; Gallup, Jack M; Kienzle, Thomas; Shelly, Daniel A; Cihlar, Tomas; King, Robert R; Ackermann, Mark R

2014-04-01

69

Extracorporeal membrane oxygenation in adults for severe acute respiratory failure.  

PubMed

The purpose of this review is to examine the indications of extracorporeal membrane oxygenation (ECMO) for severe acute respiratory distress syndrome (ARDS). This technique of oxygenation has significantly increased worldwide with the H1N1 flu pandemic. The goal of ECMO is to maintain a safe level of oxygenation and controlled respiratory acidosis under protective ventilation. The enthusiasm for ECMO should not obscure the consideration for potential associated complications. Before widespread diffusion of ECMO, new trials should test the efficacy of early initiation or CO2 removal in addition to, or even as an alternative to mechanical ventilation for severe ARDS. PMID:25128980

Rozé, H; Repusseau, B; Ouattara, A

2014-01-01

70

Home Ventilation for Children with Chronic Respiratory Failure in Istanbul  

Microsoft Academic Search

Background: The number of children on home mechanical ventilation (HMV) has increased markedly in Europe and North America but little is known about the HMV use and outcomes in children in Turkey. Objective: To review clinical conditions and outcome of children who were discharged from the hospital on respiratory support. Methods: Thirty-four patients assessed at the Marmara University Hospital in

S. Oktem; R. Ersu; Z. S. Uyan; E. Cakir; F. Karakoc; B. Karadag; G. Kiyan; E. Dagli

2008-01-01

71

Noninvasive Ventilation in Childhood Acute Neuromuscular Respiratory Failure: A Pilot Study  

Microsoft Academic Search

Background: Over a 36-month study period, 10 nonconsecutive neuromuscular pediatric patients (6 infants, mean age 10.16 months, and 4 children, mean age 9.3 years) presenting with acute respiratory failure (ARF) were treated by noninvasive positive pressure ventilation (NPPV). All patients required immediate respiratory support and fulfilled our intubation criteria. Objective: The aim of the study was to verify if early

M. Piastra; M. Antonelli; E. Caresta; A. Chiaretti; G. Polidori; G. Conti

2006-01-01

72

Modeling Common Cause Failures of Thrusters on ISS Visiting Vehicles  

NASA Technical Reports Server (NTRS)

This paper discusses the methodology used to model common cause failures of thrusters on the International Space Station (ISS) Visiting Vehicles. The ISS Visiting Vehicles each have as many as 32 thrusters, whose redundancy makes them susceptible to common cause failures. The Global Alpha Model (as described in NUREG/CR-5485) can be used to represent the system common cause contribution, but NUREG/CR-5496 supplies global alpha parameters for groups only up to size six. Because of the large number of redundant thrusters on each vehicle, regression is used to determine parameter values for groups of size larger than six. An additional challenge is that Visiting Vehicle thruster failures must occur in specific combinations in order to fail the propulsion system; not all failure groups of a certain size are critical.

Haught, Megan

2014-01-01

73

[Frontotemporal dementia with motor neuron disease diagnosed after the development of type II respiratory failure].  

PubMed

A 79-year-old woman attended the Center for Comprehensive Care of Memory Disorders at the Kyorin University Hospital in 2006 due to forgetfulness. Her initial diagnosis was vascular dementia. In 2007, her cognition declined gradually. Then, impaired verbal fluency and stuttering, the symptoms of non-fluent aphasia, were presented. Thereafter, 5 mg/day donepezil hydrochloride was prescribed. She later suffered type II respiratory failure. Needle electromyography revealed denervation of lower motor neurons. This led to the diagnosis of frontotemporal dementia with motor neuron disease. Interestingly, before developing type II respiratory failure, cognitive decline and non-fluent aphasia occurred in this case. PMID:20139654

Satomura, Hajime; Kobayashi, Yoshio; Kozaki, Koichi; Hattanmaru, Mikiko; Tanaka, Masamichi; Sato, Michiko; Moriya, Yukiko; Inoue, Shinichiro; Hasegawa, Hiroshi; Toba, Kenji

2009-01-01

74

Operator error, equipment failure caused incident  

SciTech Connect

The preliminary verdict of the Augmented Inspection Team (AIT) is that the alert at the Salem-1 pressurized water reactor on April 7 was caused by a combination of operator error and equipment malfunction. According to Robert Summers, leader of the seven-member AIT sent by the Nuclear Regulatory Commission, the sequence of events at the Public Service Electric & Gas Company (PSE&G) reactor was kicked off by grass on the Delaware River clogging the screens where circulating water is pumped in. The plant was running at a reduced power level of 75 percent to give the operators more margin to work with. But when the screens clogged, the plant quickly lost almost all circulating water. Summers told Nuclear News, {open_quotes}They were down to one pump, and that pump wasn`t really pumping much water because its screen had tripped due to high delta pressure.{close_quotes} At that time, the operators began a rapid powerdown in order to maintain backpressure in the condenser. During the powerdown, the operator failed to let his shift supervisor know that primary temperature was dropping below minimum temperature for criticality. In an attempt to raise reactor temperature again by withdrawing control rods, the operators withdrew them too fast and exceeded the 25 percent power flux trip; the reactor shut down automatically.

Zeyher, A.

1994-06-01

75

The use of high-flow nasal oxygen therapy in the management of hypercarbic respiratory failure.  

PubMed

Hypercarbic respiratory failure, occurring secondary to chronic lung disease, is a frequently encountered problem. These patients present a significant challenge to respiratory and critical care services, as many are unsuitable for mechanical ventilation and most have multiple comorbidities. Recently, noninvasive ventilation (NIV) has become established as the primary modality for respiratory support in this group of patients. Several factors limit patient compliance with NIV, not least comfort and tolerability. A recent innovation in adult critical care is the use of high-flow nasal oxygen (HFNO) devices. These systems are capable of delivering high gas flows via nasal cannulae, with the ability to blend air and oxygen to give a controlled FiO2. Few clinical studies have been conducted in adults, although several are planned. To date the majority of available evidence addresses the use of HFNO in hypoxemic respiratory failure. Here we present a case in which a HFNO system was used to successfully manage hypercarbic respiratory failure in a patient unable to tolerate conventional NIV. PMID:24670392

Millar, Jonathan; Lutton, Stuart; O'Connor, Philip

2014-04-01

76

Vitamin D Deficiency in Patients With Neuromuscular Diseases With Chronic Respiratory Failure.  

PubMed

Background: The prevalence and clinical implications of vitamin D deficiency have never been studied in patients with underlying neuromuscular diseases complicated with chronic respiratory failure. The aim of this study is to demonstrate the prevalence of vitamin D deficiency, its relationship with other bone markers, and mode of nutrition. Materials and Methods: Serum 25-hydroxyvitamin D (25[OH]D) levels along with calcium, serum albumin, and phosphorus levels were obtained from 57 patients with chronic respiratory failure due to underlying neuromuscular diseases. These levels were obtained during their first visit to a chronic respiratory diseases clinic. Data with regard to nutrition, respiratory muscle function, and level of mobility were also obtained at the same time. Results: Seventy-five percent of patients had serum 25(OH)D levels ?30 ng/mL. There is a negative correlation between parathyroid hormone and 25(OH)D levels (P = .006) and corrected calcium levels (P = .066). Serum 25(OH)D levels varied with the mode of nutrition. Patients on enteral nutrition had the highest serum levels of 25(OH)D, whereas combined oral and tube feeds had the lowest 25(OH)D levels (P = .006). Conclusion: Low serum 25(OH)D levels are highly prevalent in patients with neuromuscular disease and chronic respiratory failure. The route of nutrition has an impact on these levels. PMID:23753994

Badireddi, Sridhar; Bercher, Anita J; Holder, Jason B; Mireles-Cabodevila, Eduardo

2013-06-10

77

Early Durata lead failure caused by rib-clavicular crush.  

PubMed

The patented Optim coating was designed to prevent insulation abrasions on the Durata lead (St Jude Medical, St Paul, Minnesota) and avoid the problems that had afflicted its predecessor, the Riata silicone lead (St Jude Medical). We report a case of external insulation failure 8 months after implantation of a dual-coil Durata lead and consider the potential causes of the failure. PMID:25154804

Ahmed, Fozia Z; Allen, Stuart; Mamas, Mamas; Zaidi, Amir M

2014-10-01

78

Fiberoptic Bronchoscopy during Nasal Non-Invasive Ventilation in Acute Respiratory Failure  

Microsoft Academic Search

Background: Various methods have been described for safely performing fiberoptic bronchoscopy (FB) while applying non-invasive positive pressure ventilation (NIPPV) in patients with acute respiratory failure (ARF). Objectives: To evaluate the safety of a new method to perform FB in patients with ARF. Methods: Patients with ARF in whom FB was indicated were studied. The primary end-point was a mean drop

E. Chiner; J. N. Sancho-Chust; M. Llombart; C. Senent; A. Camarasa; J. Signes-Costa

2010-01-01

79

Cascade iatrogenesis: a case-control study to detect postoperative respiratory failure in hospitalized older adults.  

PubMed

During hospitalization, older adults are at high risk for cascade iatrogenesis, the serial development of complications. In this retrospective, descriptive, case-control pilot study, 28 patients (cases) who developed respiratory failure after an elective surgical procedure were compared to 28 matched controls who did not develop postoperative respiratory failure. The type, frequency, and timing of events that preceded the development of postoperative respiratory failure in hospitalized older adults (age 65 and older) and the presence and timing of similar events for matched controls during a postoperative period of the same length were recorded. Cases experienced certain trigger events, including atelectasis and fluid overload, at significantly higher rates than controls. Cases and controls experienced similar rates of oversedation and delirium, yet controls were less likely to aspirate following these episodes. Patients who developed postoperative respiratory failure were less likely to ambulate early and experienced more calls to rapid response or code teams, more transfers to higher levels of care, longer lengths of stay, and more deaths than matched controls. PMID:24297156

Thornlow, Deirdre K; Oddone, Eugene; Anderson, Ruth

2014-01-01

80

Morphological response to positive end expiratory pressure in acute respiratory failure. Computerized tomography study  

Microsoft Academic Search

Ten patients with acute respiratory failure (ARF), (4 pneumonia, 4 sepsis, 2 polytrauma), underwent computerized tomography (CT) of the lungs, (apex, hilum, base), at 5, 10, 15 cm H2O positive end expiratory pressure (PEEP). The ARF lungs, on CT scan, appeared as a patchwork of normal and dense areas with generally well defined boundaries. Most of the densities were found

L. Gattinoni; D. Mascheroni; A. Torresin; R. Marcolin; R. Fumagalli; S. Vesconi; G. P. Rossi; F. Rossi; S. Baglioni; F. Bassi; G. Nastri; A. Pesenti

1986-01-01

81

Mortality of Neonatal Respiratory Failure Related to Socioeconomic Factors in Hebei Province of China  

Microsoft Academic Search

Dramatic progress has occurred in neonatal intensive care in tertiary centers in mid-eastern China. We investigated the characteristics of neonatal respiratory failure (NRF) including the incidence, management, outcomes and costs in 14 neonatal intensive care units (NICUs) of Hebei, a province at an intermediate economic level in China. Over a period of 12 consecutive months in 2007–2008, perinatal data were

Li Ma; Cuiqing Liu; Yuqi Wang; Shufang Li; Shufen Zhai; Xiaofeng Gu; Fang Liu; Aixia Yan; Wei Guo; Yingyu Li; Min Xiao; Jianying Yin; Yanzhi Li; Xia Liu; Rong Wang; Haresh Kirpalani; Bo Sun

2011-01-01

82

Respiratory infection of mice with mammalian reoviruses causes systemic infection with age and strain dependent pneumonia and encephalitis  

PubMed Central

Background Because mammalian reoviruses are isolated from the respiratory tract we modeled the natural history of respiratory infection of adult and suckling mice with T1 Lang (T1L) and T3 Dearing (T3D) reoviruses. Methods Adult and suckling Balb/c mice were infected by the intranasal route and were assessed for dose response of disease as well as viral replication in the lung and other organs. Viral antigen was assessed by immunofluorescence and HRP staining of tissue sections and histopathology was assessed on formalin fixed, H?+?E stained tissue sections. Results Intranasal infection of adult mice resulted in fatal respiratory distress for high doses (107 pfu) of T1L but not T3D. In contrast both T1L and T3D killed suckling mice at moderate viral dosages (105 pfu) but differed in clinical symptoms where T1L induced respiratory failure and T3D caused encephalitis. Infections caused transient viremia that resulted in spread to peripheral tissues where disease correlated with virus replication, and pathology. Immunofluorescent staining of viral antigens in the lung showed reovirus infection was primarily associated with alveoli with lesser involvement of bronchiolar epithelium. Immunofluorescent and HRP staining of viral antigens in brain showed infection of neurons by T3D and glial cells by T1L. Conclusions These mouse models of reovirus respiratory infection demonstrated age and strain dependent disease that are expected to be relevant to understanding and modulating natural and therapeutic reovirus infections in humans. PMID:23453057

2013-01-01

83

Farmer's Lung: Causes and Symptoms of Mold and Dust Induced Respiratory Illness  

MedlinePLUS

... Educational Resources Farmer's Lung: Causes and Symptoms of Mold and Dust Induced Respiratory Illness ID 442-602 ( ... noninfectious allergic disease that is caused by inhaling mold spores in the dust from moldy hay, straw, ...

84

A complication of tracheobronchopathia osteochondroplastica presenting as acute hypercapnic respiratory failure.  

PubMed

Background Tracheobronchopathia osteochondroplastica is a rare benign and often indolent disease. We report the first case of tracheobronchopathia osteochondroplastica (TBO) presenting as acute hypercarbic respiratory failure due to superimposed subglottic submucosal abscess. Case Report A 27-year-old man presented to the emergency department in respiratory distress that required mechanical ventilation for acute hypercarbic respiratory failure. Upon extubation the next day, stridor was elicited with ambulation. Spirometry revealed fixed upper airway obstruction. Neck imaging showed a 2.8×2.0×4.0 cm partially calcified subglottic mass with cystic and solid component obstructing 75% of the airway. Surgical exploration revealed purulent drainage upon elevation of the thyroid isthmus and an anterolateral cricoid wall defect in communication with a subglottic submucosal cavity. Microbiology was negative for bacteria or fungi. Pathology showed chondro-osseous metaplasia compatible with tracheobronchopathia osteochondroplastica (TBO). The patient received a course of antibiotics and prophylactic tracheostomy. Since tracheostomy removal 3 days later, the patient remains asymptomatic. Conclusions Tracheobronchopathia osteochondroplastica is a rare disease with usually benign clinical course and incidental diagnosis. It may present as acute hypercarbic respiratory failure when subglottic infection is superimposed. PMID:25629203

Danckers, Mauricio; Raad, Roy A; Zamuco, Ronaldo; Pollack, Aron; Rickert, Scott; Caplan-Shaw, Caralee

2015-01-01

85

A Complication of Tracheobronchopathia Osteochondroplastica Presenting as Acute Hypercapnic Respiratory Failure  

PubMed Central

Patient: Male, 27 Final Diagnosis: Tracheobronchopathia osteochondroplastica Symptoms: Shortness of breath • stridor Medication: — Clinical Procedure: Neck computer tomography • pulmonary function test • neck surgical exploration • tracheostomy placement Specialty: Critical Care Medicine Objective: Unusual clinical course Background: Tracheobronchopathia osteochondroplastica is a rare benign and often indolent disease. We report the first case of tracheobronchopathia osteochondroplastica (TBO) presenting as acute hypercarbic respiratory failure due to superimposed subglottic submucosal abscess. Case Report: A 27-year-old man presented to the emergency department in respiratory distress that required mechanical ventilation for acute hypercarbic respiratory failure. Upon extubation the next day, stridor was elicited with ambulation. Spirometry revealed fixed upper airway obstruction. Neck imaging showed a 2.8×2.0×4.0 cm partially calcified subglottic mass with cystic and solid component obstructing 75% of the airway. Surgical exploration revealed purulent drainage upon elevation of the thyroid isthmus and an anterolateral cricoid wall defect in communication with a subglottic submucosal cavity. Microbiology was negative for bacteria or fungi. Pathology showed chondro-osseous metaplasia compatible with tracheobronchopathia osteochondroplastica (TBO). The patient received a course of antibiotics and prophylactic tracheostomy. Since tracheostomy removal 3 days later, the patient remains asymptomatic. Conclusions: Tracheobronchopathia osteochondroplastica is a rare disease with usually benign clinical course and incidental diagnosis. It may present as acute hypercarbic respiratory failure when subglottic infection is superimposed. PMID:25629203

Danckers, Mauricio; Raad, Roy A.; Zamuco, Ronaldo; Pollack, Aron; Rickert, Scott; Caplan-Shaw, Caralee

2015-01-01

86

Heart failure in older people: causes, diagnosis and treatment  

Microsoft Academic Search

Congestive heart failure affects )5% of those aged 65-75 and 10-20% of those aged )80 in the UK, and levels are likely to rise in the wake of improved therapies for hypertension and myocardial infarction. It is often multifactorial in this group. The most common causes are hypertension and coronary heart disease, with valvular heart disease playing an increasing role.

AHMED H. ABDELHAFIZ

2002-01-01

87

Obstructive sleep apnoea: longer respiratory event lengths in patients with heart failure.  

PubMed

This study investigated the effect of heart failure on respiratory patterns in patients with obstructive sleep apnoea (OSA). 39 patients with established OSA (apnoea/hypopnoea index (AHI) >10 events·h(-1)) and either with heart failure (New York Heart Association (NYHA) class II and III, left ventricular-ejection fraction (LVEF) ?40%; n=26, age mean ± SD 67 ± 9 years) or without heart failure (LVEF ?50%, N-terminal pro-brain naturic peptide <400 pg·mL(-1); n=13, age 73 ± 6 years) underwent simultaneous right- and left-heart catheterisation within 12 h of cardiorespiratory polygraphy recording. Respiratory patterns of OSA were significantly longer in OSA patients with heart failure versus without heart failure, including mean ± SD cycle length (46.0 ± 10.0 versus 37.8 ± 10.6 s; p=0.024), ventilation length (25.4 ± 6.3 versus 21.3 ± 7.1 s; p=0.044), apnoea length (20.5 ± 4.9 versus 16.5 ± 3.9 s; p=0.013), time-to-peak ventilation (10.6 ± 3.0 versus 8.3 ± 2.5 sc; p=0.021) and circulatory delay (28.5 ± 7.5 versus 22.6 ± 3.7 s; p=0.005). Positive and robust correlations were found between some of these parameters and the degree of congestion in heart failure: cycle length (r=0.53; p=0.006), ventilation length (r=0.55; p=0.004) and time-to-peak ventilation (r=0.47; p=0.015) all increased with a rise in pulmonary capillary wedge pressure. Respiratory patterns in OSA appear to be dependent on cardiac function, with an increase in event lengths as cardiac function decreases. In patients with heart failure, some of these events correlate with the degree of pulmonary congestion. PMID:23018907

Efken, Christina; Bitter, Thomas; Prib, Natalie; Horstkotte, Dieter; Oldenburg, Olaf

2013-06-01

88

Genetics Home Reference: Hereditary myopathy with early respiratory failure  

MedlinePLUS

... to provide structure, flexibility, and stability to these cell structures. Titin also plays a role in chemical signaling and in assembling new sarcomeres. The TTN gene mutation ... of the altered gene in each cell is sufficient to cause the disorder. In most ...

89

Relationships between lung computed tomographic density, gas exchange, and PEEP in acute respiratory failure.  

PubMed

Twenty-two patients with acute respiratory failure underwent lung computed tomography (CT) and physiological measurements at 5, 10, and 15 cm H2O positive end-expiratory pressure (PEEP) to investigate the relationship between morphology and function. Lung densities were primarily concentrated in the dependent regions. From the frequency distribution of CT numbers (difference in x-ray attenuation between water and lung) and lung gas volume measurements the authors obtained a quantitative estimate of normally inflated, poorly inflated, and non-inflated lung tissue weight. This estimated average lung weight was increased twofold above normal and excess lung weight correlated with the mean pulmonary artery pressure (P less than 0.01). Venous admixture correlated with the non-inflated tissue mass (P less than 0.01). Increasing PEEP caused progressive clearing of radiographic densities and increased the mass of normally inflated tissue (anatomic recruitment), while reducing venous admixture. The cardiac index decreased after increasing PEEP while oxygen delivery was unchanged. The authors conclude that CT scan lung density and oxygen exchange efficiency are correlated; the main effect of augmenting PEEP is to recruit perfused alveolar units that were previously collapsed. PMID:3057937

Gattinoni, L; Pesenti, A; Bombino, M; Baglioni, S; Rivolta, M; Rossi, F; Rossi, G; Fumagalli, R; Marcolin, R; Mascheroni, D

1988-12-01

90

Extracorporeal life support for 100 adult patients with severe respiratory failure.  

PubMed Central

OBJECTIVE: The authors retrospectively reviewed their experience with extracorporeal life support (ECLS) in 100 adult patients with severe respiratory failure (ARF) to define techniques, characterize its efficacy and utilization, and determine predictors of outcome. SUMMARY BACKGROUND DATA: Extracorporeal life support maintains gas exchange during ARF, providing diseased lungs an optimal environment in which to heal. Extracorporeal life support has been successful in the treatment of respiratory failure in infants and children. In 1990, the authors instituted a standardized protocol for treatment of severe ARF in adults, which included ECLS when less invasive methods failed. METHODS: From January 1990 to July 1996, the authors used ECLS for 100 adults with severe acute hypoxemic respiratory failure (n = 94): paO2/FiO2 ratio of 55.7+/-15.9, transpulmonary shunt (Qs/Qt) of 52+/-22%, or acute hypercarbic respiratory failure (n = 6): paCO2 84.0+/-31.5 mmHg, despite and after maximal conventional ventilation. The technique included venovenous percutaneous access, lung "rest," transport on ECLS, minimal anticoagulation, hemofiltration, and optimal systemic oxygen delivery. RESULTS: Overall hospital survival was 54%. The duration of ECLS was 271.9+/-248.6 hours. Primary diagnoses included pneumonia (49 cases, 53% survived), adult respiratory distress syndrome (45 cases, 51 % survived), and airway support (6 cases, 83% survived). Multivariate logistic regression modeling identified the following pre-ECLS variables significant independent predictors of outcome: 1) pre-ECLS days of mechanical ventilation (p = 0.0003), 2) pre-ECLS paO2/FiO2 ratio (p = 0.002), and 3) age (years) (p = 0.005). Modeling of variables during ECLS showed that no mechanical complications were independent predictors of outcome, and the only patient-related complications associated with outcome were the presence of renal failure (p < 0.0001) and significant surgical site bleeding (p = 0.0005). CONCLUSIONS: Extracorporeal life support provides life support for ARF in adults, allowing time for injured lungs to recover. In 100 patients selected for high mortality risk despite and after optimal conventional treatment, 54% survived. Extracorporeal life support is extraordinary but reasonable treatment in severe adult respiratory failure. Predictors of survival exist that may be useful for patient prognostication and design of future prospective studies. Images Figure 1. Figure 2. Figure 3. Figure 4. Figure 5. PMID:9351722

Kolla, S; Awad, S S; Rich, P B; Schreiner, R J; Hirschl, R B; Bartlett, R H

1997-01-01

91

Hancock bioprosthetic valve failure: causes, and results of reoperation.  

PubMed

Between March 1970 and the end of December 1986, 180 porcine valve recipients underwent reoperation at our institution because of bioprosthetic failure. Of these patients, 126 (70.0%) had mitral bioprosthesis replacement (MBR), which was necessitated because of primary tissue failure in 107 cases, prosthetic valve endocarditis in eight cases, and paravalvular leakage in eleven cases. Forty-six patients (25.5%) had aortic bioprosthesis replacement (ABR), owing to primary tissue failure in 37 cases, endocarditis in six cases, and paravalvular leakage in three cases. The remaining eight patients (4.5%) all underwent double (mitral and aortic) bioprosthesis replacement (DBR) because of primary tissue failure. In a total of 152 patients who underwent reoperation for primary tissue failure, the hospital mortality was 6.5% for the MBR group, 8.0% for the ABR group, and 0% for the DBR group (mean, 6.5%). In those 14 patients who required reoperation owing to endocarditis, the hospital mortality was 75% for the MBR group and 50% for the ABR group (mean, 64%). In another 14 patients who underwent reoperation because of paravalvular leakage, the hospital mortality was 9% for the MBR group and 0% for the ABR group (mean, 7%). Morphologic studies of the explanted valves revealed that tissue calcification is the most frequent cause of primary tissue failure in Hancock-valve recipients. Calcification leads to cusp stiffening with stenosis or to cuspal and commissural rupture with incompetence. Usually, primary tissue failure causes progressive dysfunction that allows for elective reoperation, which is associated with a low mortality; rarely, however, porcine xenograft failure can occur acutely and require emergency operation, which is associated with a significantly higher risk. Such operation was necessary in nine (6%) of our patients with primary tissue failure and resulted in four deaths (44%); conversely, elective reoperation was done in 143 patients with other primary tissue failure (94%) and resulted in six deaths (4%) (p<0.001). Our long-term experience with the Hancock bioprosthesis confirms that this valve's durability is limited. Therefore, we believe that the indications for the use of porcine bioprostheses should be restricted, until consistent data become available concerning the durability of the new generation of prosthetic valves. PMID:15227274

Bortolotti, U; Milano, A; Mazzucco, A; Guerra, F; Magni, A; Thiene, G; Gallucci, V

1988-01-01

92

Reliability Evaluation of Distributed Computer Systems Subject to Imperfect Coverage and Dependent Common-Cause Failures  

Microsoft Academic Search

Imperfect coverage (IPC) occurs when a malicious component failure causes extensive damage due to inadequate fault detection, fault location or fault recovery. Common-cause failures (CCF) are multiple dependent component failures within a system due to a shared root cause. Both imperfect coverage and common-cause failures can exist in distributed computer systems and can contribute significantly to the overall system unreliability.

Liudong Xing; Akhilesh Shrestha

2006-01-01

93

Noninvasive positive pressure ventilation as treatment for acute respiratory failure in critically ill patients  

PubMed Central

Our current state of knowledge on noninvasive positive pressure ventilation (NPPV) and technical aspects are discussed in the present review. In patients with chronic obstructive pulmonary disease, NPPV can be considered a valid therapeutic option to prevent endotracheal intubation. Evidence suggests that, before eventual endotracheal intubation, NPPV should be considered as first-line intervention in the early phases of acute exacerbation of chronic obstructive pulmonary disease. Small randomized and non-randomized studies on the application of NPPV in patients with acute hypoxaemic respiratory failure showed promising results, with reduction in complications such as sinusitis and ventilator-associated pneumonia, and in the duration of intensive care unit stay. The conventional use of NPPV in hypoxaemic acute respiratory failure still remains controversial, however. Large randomized studies are still needed before extensive clinical application in this condition. PMID:11094492

Antonelli, Massimo; Conti, Giorgio

2000-01-01

94

REPRESENTING COMMON-CAUSE FAILURES IN THE SAPHIRE SOFTWARE  

SciTech Connect

Currently, the risk analysis software SAPHIRE has implemented a common-cause failure (CCF) module to represent standard CCF methods such as alpha-factor and multiple Greek letter approaches. However, changes to SAPHIRE are required to support the Nuclear Regulatory Commission’s 2007 “Risk Assessment Standardization Project” CCF analysis guidance for events assessment. This guidance provides an outline of how both the nominal CCF probabilities and conditional (e.g., after a redundant component has failed) CCF probabilities should be calculated. Based upon user-provided input and extending the limitations in the current version of SAPHIRE, the CCF module calculations will be made consistent with the new guidance. The CCF modifications will involve changes to (1) the SAPHIRE graphical user interface directing how end-users and modelers interface with PRA models and (2) algorithmic changes as required. Included in the modifications will be the possibility to treat CCF probability adjustments based upon failure types (e.g., independent versus dependent) and failure modes (e.g., failure-to-run versus failure-to-start). In general, SAPHIRE is being modified to allow the risk analyst to define a CCF object. This object is defined in terms of a basic event. For the CCF object, the analyst would need to specify a minimal set of information, including: - The number of redundant components - The failure criteria (how many component have to fail) - The CCF model type (alpha-factor, MGL, or beta-factor) - The parameters (e.g., the alpha-factors) associated with the model - Staggered or non-staggered testing assumption - Default level of detail (expanded, showing all of the specific failure combinations, or not) This paper will outline both the theory behind the probabilistic calculations and the resulting implementation in the SAPHIRE software.

Curtis L. Smith

2008-11-01

95

Telemedicine to support end of life in severe chronic respiratory failure patients at home  

Microsoft Academic Search

Tele hospice has been demonstrated useful and cost saving for palliative care. The aim of the present study was to analyze\\u000a the feasibility of impact of a telemedicine (TM) programme on severe chronic respiratory failure (CRF) patients discharged\\u000a to home, their family and the healthcare team (HCT) in the terminal phase of life. TM consisted of scheduled phone calls,\\u000a pulse-oximetry

M. Vitacca; G. Assoni; S. Gilè; D. Fiorenza; L. Bianchi; L. Barbano; R. Porta; E. Bertella; S. Scalvini

2009-01-01

96

A comparison of volume control and pressure-regulated volume control ventilation in acute respiratory failure  

PubMed Central

Background: The aim of this study was to test the hypothesis that a new mode of ventilation (pressure-regulated volume control; PRVC) is associated with improvements in respiratory mechanics and outcome when compared with conventional volume control (VC) ventilation in patients with acute respiratory failure. We conducted a randomised, prospective, open, cross over trial on 44 patients with acute respiratory failure in the general intensive care unit of a university hospital. After a stabilization period of 8 h, a cross over trial of 2 × 2 h was conducted. Apart from the PRVC/VC mode, ventilator settings were comparable. The following parameters were recorded for each patient: days on ventilator, failure in the assigned mode of ventilation (peak inspiratory pressure > 50 cmH2O) and survival. Results: In the crossover trial, peak inspiratory pressure was significantly lower using PRVC than with VC (20 cmH2O vs 24 cmH2O, P < 0.0001). No other statistically significant differences were found. Conclusions: Peak inspiratory pressure was significantly lower during PRVC ventilation than during VC ventilation, and thus PRVC may be superior to VC in certain patients. However, in this small group of patients, we could not demonstrate that PRVC improved outcome. PMID:11056699

Guldager, Henrik; Nielsen, Soeren L; Carl, Peder; Soerensen, Mogens B

1997-01-01

97

Insights About Emergency Diesel Generator Failures from the USNRC's Common Cause Failure Database  

SciTech Connect

The US Nuclear Regulatory Commission has sponsored development of a database of common cause failure events for use in commercial nuclear power plant risk and reliability analyses. This paper presents a summary of the results from analysis of the emergency diesel generator data from the database. The presentation is limited to the overall insights, the design and manufacturing cause and the instrumentation and control sub-system.

Mosleh, A. [Univ. of Maryland, MD (US); Rasmuson, D. [USNRC (US); Marshall, F.; Wierman, T. [INEEL (US)

1999-08-01

98

A rare cause of pacemaker failure: interatrial block.  

PubMed

Pacemaker and implantable cardioverter defibrillators (ICD) systems are useful in detection and differentiation of many symptomatic and asymptomatic arrhythmias. In this report, we described a rare condition that caused by failure in detection of a clinical tachyarrhythmia by a dual chamber pacemaker that implanted because of intermittent atrioventricular (AV) block and sinus node disease in a 46-year-old patient. In our case, bidirectional interatrial block was demonstrated; and the symptoms associated with high ventricular rate caused by left atrial tachyarrhythmias relieved after AV node ablation. PMID:24047493

Demircan, Sabri; Yuksel, Serkan; Gulel, Okan

2013-09-01

99

Middle East respiratory syndrome coronavirus (MERS-CoV) causes transient lower respiratory tract infection in rhesus macaques  

PubMed Central

In 2012, a novel betacoronavirus, designated Middle East respiratory syndrome coronavirus or MERS-CoV and associated with severe respiratory disease in humans, emerged in the Arabian Peninsula. To date, 108 human cases have been reported, including cases of human-to-human transmission. The availability of an animal disease model is essential for understanding pathogenesis and developing effective countermeasures. Upon a combination of intratracheal, ocular, oral, and intranasal inoculation with 7 × 106 50% tissue culture infectious dose of the MERS-CoV isolate HCoV-EMC/2012, rhesus macaques developed a transient lower respiratory tract infection. Clinical signs, virus shedding, virus replication in respiratory tissues, gene expression, and cytokine and chemokine profiles peaked early in infection and decreased over time. MERS-CoV caused a multifocal, mild to marked interstitial pneumonia, with virus replication occurring mainly in alveolar pneumocytes. This tropism of MERS-CoV for the lower respiratory tract may explain the severity of the disease observed in humans and the, up to now, limited human-to-human transmission. PMID:24062443

de Wit, Emmie; Rasmussen, Angela L.; Falzarano, Darryl; Bushmaker, Trenton; Brining, Douglas L.; Fischer, Elizabeth R.; Martellaro, Cynthia; Okumura, Atsushi; Chang, Jean; Scott, Dana; Benecke, Arndt G.; Katze, Michael G.; Feldmann, Heinz; Munster, Vincent J.

2013-01-01

100

Non-invasive mechanical ventilation in acute respiratory failure due to chronic obstructive pulmonary disease: correlates for success  

Microsoft Academic Search

BACKGROUND--Non-invasive mechanical ventilation is increasingly used in the treatment of acute respiratory failure in patients with chronic obstructive pulmonary disease (COPD). The aim of this study was to identify simple parameters to predict the success of this technique. METHODS--Fifty nine episodes of acute respiratory failure in 47 patients with COPD treated with non-invasive mechanical ventilation were analysed, considering each one

N Ambrosino; K Foglio; F Rubini; E Clini; S Nava; M Vitacca

1995-01-01

101

Description: Swine influenza (swine flu) is a respiratory disease of pigs caused by type A influenza viruses that cause regular  

E-print Network

Description: Swine influenza (swine flu) is a respiratory disease of pigs caused by type A influenza viruses that cause regular outbreaks in pigs. People do not usually get swine flu, but human infections can and do happen. Swine flu viruses have been reported to spread from person to person

Blows, Mark

102

ISS Fiber Optic Failure Investigation Root Cause Report  

NASA Technical Reports Server (NTRS)

In August of 1999, Boeing Corporation (Boeing) engineers began investigating failures of optical fiber being used on International Space Station flight hardware. Catastrophic failures of the fiber were linked to a defect in the glass fiber. Following several meetings of Boeing and NASA engineers and managers, Boeing created and led an investigation team, which examined the reliability of the cable installed in the U.S. Lab. NASA Goddard Space Flight Center's Components Technologies and Radiation Effects Branch (GSFC) led a team investigating the root cause of the failures. Information was gathered from: regular telecons and other communications with the investigation team, investigative trips to the cable distributor's plant, the cable manufacturing plant and the fiber manufacturing plant (including a review of build records), destructive and non-destructive testing, and expertise supplied by scientists from Dupont, and Lucent-Bell Laboratories. Several theories were established early on which were not able to completely address the destructive physical analysis and experiential evidence. Lucent suggested hydrofluoric acid (HF) etching of the glass and successfully duplicated the "rocket engine" defect. Strength testing coupled with examination of the low strength break sites linked features in the polyimide coating with latent defect sites. The information provided below explains what was learned about the susceptibility of the pre-cabled fiber to failure when cabled as it was for Space Station and the nature of the latent defects.

Leidecker, Henning; Plante, Jeannette

2000-01-01

103

Bronchoscopic intubation during continuous nasal positive pressure ventilation in the treatment of hypoxemic respiratory failure.  

PubMed

Endotracheal intubation is difficult in patients with hypoxemic respiratory failure who deteriorate despite treatment with noninvasive positive pressure ventilation (NIPPV). Maintaining NIPPV during intubation may prevent alveolar derecruitment and deterioration in gas exchange. We report a case series of 10 nonconsecutive patients with NIPPV failure who were intubated via a flexible bronchoscope during nasal mask positive pressure ventilation. All 10 patients were intubated in the first attempt. Hypotension was the most frequent complication (33%). Mean decrease in oxyhemoglobin saturation during the procedure was 4.7 ± 3.1. This method of intubation may extend the benefits of preoxygenation throughout the whole process of endotracheal intubation. It requires an experienced operator and partially cooperative patients. A prospective trial is necessary to determine the best intubation method for NIPPV failure. PMID:24243561

Barjaktarevic, Igor; Berlin, David

2015-03-01

104

Are you protected against Pertussis? Pertussis, or whooping cough, is a highly contagious respiratory infection caused by the bacterium  

E-print Network

Are you protected against Pertussis? Pertussis, or whooping cough, is a highly contagious respiratory infection caused by the bacterium Bordetella pertussis. It causes severe coughing spells, vomiting

105

Acute renal failure enhances the antidotal activity of pralidoxime towards paraoxon-induced respiratory toxicity.  

PubMed

We recently showed in a rat model of dichromate-induced acute renal failure (ARF) that the elimination but not the distribution of pralidoxime was altered resulting in sustained plasma pralidoxime concentrations. The aim of this study was to compare the efficiency of pralidoxime in normal and acute renal failure rats against paraoxon-induced respiratory toxicity. Ventilation at rest was assessed using whole-body plethysmography after subcutaneous administration of either saline or paraoxon (50% of the LD(50)), in the control and ARF rats. Thirty minutes after administration of paraoxon, either saline or 50mg/kg of pralidoxime was administered intramuscularly. ARF had no significant effects on the ventilation at rest. The effects of paraoxon on respiration were not significantly different in the control and ARF group. Paraoxon increased the total time (T(TOT)), expiratory time (T(E)) and tidal volume (V(T)), and decreased the respiratory frequency (f). In paraoxon-poisoned rats with normal renal function, pralidoxime had a significant but transient effect regarding the T(TOT) and V(T) (p<0.05). In the ARF group, the same dose of pralidoxime significantly decreased the T(TOT), T(E), and V(T) and increased f during 90 min (p<0.01). In conclusion, pralidoxime had partial and transient effects towards paraoxon-induced respiratory toxicity in control rats; and a complete and sustained correction in ARF rats. PMID:19406220

Kayouka, Maya; Houzé, Pascal; Debray, Marcel; Baud, Frederic J

2009-08-25

106

Incidence and causes of non-invasive mechanical ventilation failure after initial success  

PubMed Central

BACKGROUND—The rate of failure of non-invasive mechanical ventilation (NIMV) in patients with chronic obstructive pulmonary disease (COPD) with acute respiratory insufficiency ranges from 5% to 40%. Most of the studies report an incidence of "late failure" (after >48 hours of NIMV) of about 10-20%. The recognition of this subset of patients is critical because prolonged application of NIMV may unduly delay the time of intubation.?METHODS—In this multicentre study the primary aims were to assess the rate of "late NIMV failure" and possible associated predictive factors; secondary aims of the study were evaluation of the best ventilatory strategy in this subset of patients and their outcomes in and out of hospital. The study was performed in two respiratory intensive care units (ICUs) on patients with COPD admitted with an episode of hypercapnic respiratory failure (mean (SD) pH 7.23(0.07), PaCO2 85.3 (15.8) mm Hg).?RESULTS—One hundred and thirty seven patients initially responded to NIMV in terms of objective (arterial blood gas tensions) and subjective improvement. After 8.4 (2.8) days of NIMV 31 patients (23%; 95% confidence interval (CI) 18 to 33) experienced a new episode of acute respiratory failure while still ventilated. The occurrence of "late NIMV failure" was significantly associated with functional limitations (ADL scale) before admission to the respiratory ICU, the presence of medical complications (particularly hyperglycaemia), and a lower pH on admission. Depending on their willingness or not to be intubated, the patients received invasive ventilation (n=19) or "more aggressive" (more hours/day) NIMV (n=12). Eleven (92%) of those in this latter subgroup died while in the respiratory ICU compared with 10 (53%) of the patients receiving invasive ventilation. The overall 90 day mortality was 21% and, after discharge from hospital, was similar in the "late NIMV failure" group and in patients who did not experience a second episode of acute respiratory failure.?CONCLUSIONS—The chance of COPD patients with acute respiratory failure having a second episode of acute respiratory failure after an initial (first 48 hours) successful response to NIMV is about 20%. This event is more likely to occur in patients with more severe functional and clinical disease who have more complications at the time of admission to the ICU. These patients have a very poor in-hospital prognosis, especially if NIMV is continued rather than prompt initiation of invasive ventilation.?? PMID:10992532

Moretti, M.; Cilione, C.; Tampieri, A.; Fracchia, C.; Marchioni, A.; Nava, S.

2000-01-01

107

[A case of sarcoidosis presenting with high fever and rash progressing to acute respiratory failure].  

PubMed

A 66-year-old man who had been given a clinical diagnosis of vasculitis at another hospital after presenting with high fever and rash was admitted to our hospital for further examination following a relapse of fever during steroid reduction. The biopsy specimens of the leg with crusts showed the presence of epithelioid granuloma, and because of a negative tuberculin test, increased serum angiotensin converting enzyme (ACE) and lysozyme levels, and pulmonary Ga uptake, the patient was given a diagnosis of sarcoidosis. Although the patient had been treated on an outpatient basis following resolution of fever with NSAIDs and 5 mg prednisolone (PSL), he suffered acute respiratory failure during follow-up and required emergency admission. Chest CT revealed bilateral ground-glass opacity and pleural effusion, and serum ACE and soluble IL2R levels were significantly elevated. We diagnosed acute exacerbation of sarcoidosis and given high dose steroid therapy. The patient's symptoms, image findings, blood test results, and other findings promptly improved. Here we reported a highly unusual presentation of acute respiratory failure in sarcoidosis. PMID:17929471

Shibata, Seiko; Saito, Kazuhito; Ishiwata, Nobuo; Ieki, Ryuji

2007-09-01

108

Functional bladder neck obstruction: a rare cause of renal failure.  

PubMed

We studied 7 men and 6 women (average age 33 years) who presented in renal failure with obstructive voiding symptoms or retention. Of these patients 11 had a dilated upper tract and 2 had shrunken kidneys. Mean serum creatinine at presentation was 7.0 mg./dl. No abnormality was noted on cysto-panendoscopy, retrograde urethrography and voiding cystourethrography. The patients were initially treated with clean intermittent self-catheterization following 7 to 10 days of indwelling catheterization. The majority of patients had low pressure and low flow rate at initial presentation but high end filling pressure (mean 35.3 cm. water), high voiding pressure (mean 118.9 cm. water), high opening pressure (mean 95.3 cm. water) and low peak flow (mean 5.7 ml. per second) on video pressure flow electromyography. The external sphincter was relaxed during voiding but the bladder neck opened intermittently or inadequately. No proper funneling of the bladder neck was seen. Thus, functional bladder neck obstruction was considered to be responsible for obstructive voiding in these patients. Of the patients 3 void to completion with the help of alpha blockers alone, 5 underwent bladder neck incision and are voiding well, and 5 were practicing clean intermittent self-catheterization at last followup. Serum creatinine returned to near normal in 10 patients. End stage renal failure persisted in 2 patients, 1 of whom underwent renal transplantation and is voiding well but the other died without having undergone renal replacement therapy. In the remaining patient serum creatinine was stable at 3.2 mg./dl. Mean serum creatinine at 6 months of followup was 2.33 mg.%. Bladder neck obstruction is a rare cause of renal failure which can be corrected if treated appropriately. PMID:7776419

Kumar, A; Banerjee, G K; Goel, M C; Mishra, V K; Kapoor, R; Bhandari, M

1995-07-01

109

Retroperitoneal Fibrosis: A Rare Cause of Acute Renal Failure  

PubMed Central

Introduction. Retroperitoneal fibrosis is a rare cause of acute renal failure (ARF) with only a handful of cases reported in literature. We report a case of a 40-year-old male with an incidental finding of retroperitoneal fibrosis. Case Presentation. Patient is a 40-year-old African American male with no significant past medical history who presented with a four-month history of low back pain and associated nausea with vomiting. Physical examination was significant for elevated blood pressure at 169/107?mmhg and bilateral pedal edema. Significant admission laboratory include blood urea nitrogen (BUN) of 108?mg/dL, serum creatinine (Cr) of 23?mg/dL, bicarbonate of 19?mg/dL, and potassium of 6.2?mmL/L. Renal ultrasound showed bilateral hydronephrosis. Post-void residual urine volume was normal. Abdominopelvic CT scan showed retroperitoneal fibrosis confirmed with fine-needle biopsy. He was treated with a combination of bilateral ureteral stent placement, hemodialysis, and steroid therapy. Four months after hospital discharge, his BUN and Cr levels Improved to 18?mg/dL and 1.25?mg/dL, respectively. Conclusion. Retroperitoneal fibrosis should be considered as a differential diagnosis in patients with acute renal failure and obstructive uropathy. Abdominal CT scan is the examination of choice for diagnosis. Full resolution with treatment depends on the duration of obstruction. PMID:24533204

Ezimora, Amaka; Faulkner, Marquetta L.; Adebiyi, Oluwafisayo; Ogungbemile, Abimbola; Marianna, Salas-Vega; Nzerue, Chike

2012-01-01

110

Noninvasive Positive Pressure Ventilation for Acute Respiratory Failure Patients With Chronic Obstructive Pulmonary Disease (COPD)  

PubMed Central

Executive Summary In July 2010, the Medical Advisory Secretariat (MAS) began work on a Chronic Obstructive Pulmonary Disease (COPD) evidentiary framework, an evidence-based review of the literature surrounding treatment strategies for patients with COPD. This project emerged from a request by the Health System Strategy Division of the Ministry of Health and Long-Term Care that MAS provide them with an evidentiary platform on the effectiveness and cost-effectiveness of COPD interventions. After an initial review of health technology assessments and systematic reviews of COPD literature, and consultation with experts, MAS identified the following topics for analysis: vaccinations (influenza and pneumococcal), smoking cessation, multidisciplinary care, pulmonary rehabilitation, long-term oxygen therapy, noninvasive positive pressure ventilation for acute and chronic respiratory failure, hospital-at-home for acute exacerbations of COPD, and telehealth (including telemonitoring and telephone support). Evidence-based analyses were prepared for each of these topics. For each technology, an economic analysis was also completed where appropriate. In addition, a review of the qualitative literature on patient, caregiver, and provider perspectives on living and dying with COPD was conducted, as were reviews of the qualitative literature on each of the technologies included in these analyses. The Chronic Obstructive Pulmonary Disease Mega-Analysis series is made up of the following reports, which can be publicly accessed at the MAS website at: http://www.hqontario.ca/en/mas/mas_ohtas_mn.html. Chronic Obstructive Pulmonary Disease (COPD) Evidentiary Framework Influenza and Pneumococcal Vaccinations for Patients With Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Smoking Cessation for Patients With Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Community-Based Multidisciplinary Care for Patients With Stable Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Pulmonary Rehabilitation for Patients With Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Long-term Oxygen Therapy for Patients With Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Noninvasive Positive Pressure Ventilation for Acute Respiratory Failure Patients With Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Noninvasive Positive Pressure Ventilation for Chronic Respiratory Failure Patients With Stable Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Hospital-at-Home Programs for Patients With Acute Exacerbations of Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Home Telehealth for Patients With Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Cost-Effectiveness of Interventions for Chronic Obstructive Pulmonary Disease Using an Ontario Policy Model Experiences of Living and Dying With COPD: A Systematic Review and Synthesis of the Qualitative Empirical Literature For more information on the qualitative review, please contact Mita Giacomini at: http://fhs.mcmaster.ca/ceb/faculty_member_giacomini.htm. For more information on the economic analysis, please visit the PATH website: http://www.path-hta.ca/About-Us/Contact-Us.aspx. The Toronto Health Economics and Technology Assessment (THETA) collaborative has produced an associated report on patient preference for mechanical ventilation. For more information, please visit the THETA website: http://theta.utoronto.ca/static/contact. Objective The objective of this evidence-based analysis was to examine the effectiveness, safety, and cost-effectiveness of noninvasive positive pressure ventilation (NPPV) in the following patient populations: patients with acute respiratory failure (ARF) due to acute exacerbations of chronic obstructive pulmonary disease (COPD); weaning of COPD patients from invasive mechanical ventilation (IMV); and prevention of or treatment of recurrent respiratory failure in COPD patients after ex

McCurdy, BR

2012-01-01

111

Acute respiratory failure secondary to eosinophilic pneumonia following influenza vaccination in an elderly man with chronic obstructive pulmonary disease.  

PubMed

Acute respiratory failure with diffuse pulmonary opacities is an unusual manifestation following influenza vaccination. We report herein a patient with chronic obstructive pulmonary disease who developed fever with worsening of respiratory symptoms and severe hypoxemia requiring ventilatory support shortly after influenza vaccination. Bronchoalveolar lavage was compatible with acute eosinophilic pneumonia. Rapid clinical improvement was observed 2 weeks after systemic corticosteroid treatment, followed by radiographic improvement at 4 weeks. No disease recurrence was observed at the 6-month follow-up. PMID:24981428

Pornsuriyasak, Prapaporn; Suwatanapongched, Thitiporn; Klaewsongkram, Jettanong; Buranapraditkun, Supranee; Rotjanapan, Porpon

2014-09-01

112

Targeted inactivation of the murine Abca3 gene leads to respiratory failure in newborns with defective lamellar bodies  

SciTech Connect

Mutations in the human ABCA3 gene, encoding an ABC-transporter, are associated with respiratory failure in newborns and pediatric interstitial lung disease. In order to study disease mechanisms, a transgenic mouse model with a disrupted Abca3 gene was generated by targeting embryonic stem cells. While heterozygous animals developed normally and were fertile, individuals homozygous for the altered allele (Abca3-/-) died within one hour after birth from respiratory failure, ABCA3 protein being undetectable. Abca3-/- newborns showed atelectasis of the lung in comparison to a normal gas content in unaffected or heterozygous littermates. Electron microscopy demonstrated the absence of normal lamellar bodies in type II pneumocytes. Instead, condensed structures with apparent absence of lipid content were found. We conclude that ABCA3 is required for the formation of lamellar bodies and lung surfactant function. The phenotype of respiratory failure immediately after birth corresponds to the clinical course of severe ABCA3 mutations in human newborns.

Hammel, Markus [Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University Munich, Lindwurmstrasse 4, 80337 Munich (Germany); Michel, Geert [GSF-National Research Center for Environment and Health, Institute of Experimental Genetics, Ingolstaedter Landstrasse 1, 85764 Neuherberg (Germany); Hoefer, Christina [GSF-National Research Center for Environment and Health, Institute of Experimental Genetics, Ingolstaedter Landstrasse 1, 85764 Neuherberg (Germany); Klaften, Matthias [GSF-National Research Center for Environment and Health, Institute of Experimental Genetics, Ingolstaedter Landstrasse 1, 85764 Neuherberg (Germany); Mueller-Hoecker, Josef [Institute of Pathology, Ludwig-Maximilians-University Munich, Thalkirchner Strasse 36, 80337 Munich (Germany); Angelis, Martin Hrabe de [GSF-National Research Center for Environment and Health, Institute of Experimental Genetics, Ingolstaedter Landstrasse 1, 85764 Neuherberg (Germany); Holzinger, Andreas [Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University Munich, Lindwurmstrasse 4, 80337 Munich (Germany)]. E-mail: andreas.holzinger@med.uni-muenchen.de

2007-08-10

113

Etiology and Outcome of Patients with HIV Infection and Respiratory Failure Admitted to the Intensive Care Unit.  

PubMed

Background. Although access to HAART has prolonged survival and improved quality of life, HIV-infected patients with severe immunosuppression or comorbidities may develop complications that require critical care support. Our objective is to evaluate the etiology of respiratory failure in patients with HIV infection admitted to the ICU, its relationship with the T-lymphocytes cell count as well as the use of HAART, and its impact on outcome. Methods. A single-center, prospective, and observational study among all patients with HIV-infection and respiratory failure admitted to the ICU from December 1, 2011, to February 28, 2013, was conducted. Results. A total of 42 patients were admitted during the study period. Their median CD4 cell count was 123 cells/ ? L (mean 205.7, range 2.0-694.0), with a median HIV viral load of 203.5 copies/mL (mean 58,676, range <20-367,649). At the time of admission, 23 patients (54.8%) were receiving HAART. Use of antiretroviral therapy at ICU admission was not associated with survival, but it was associated with higher CD4 cell counts and lower HIV viral loads. Twenty-five patients (59.5%) had respiratory failure secondary to non-HIV-related diseases. Mechanical ventilation was required in 36 patients (85.1%). Thirteen patients (31.0%) died. Conclusions. Noninfectious etiologies of respiratory failure account for majority of HIV-infected patients admitted to ICU. Increased mortality was observed among patients with sepsis as etiology of respiratory failure (HIV related and non-AIDS related), in those receiving mechanical ventilation, and in patients with decreased CD4 cell count. Survival was not associated with the use of HAART. Complementary studies are warranted to address the impact of HAART on outcomes of HIV-infected patients with respiratory failure admitted to ICU. PMID:24065988

Orsini, Jose; Ahmad, Noeen; Butala, Ashvin; Flores, Rosemarie; Tran, Truc; Llosa, Alfonso; Fishkin, Edward

2013-01-01

114

Just a sore throat? Uncommon causes of significant respiratory disease.  

PubMed

We present two uncommon underlying causes of a sore throat which, if missed or delayed in diagnosis, can lead to disastrous consequences. Our first case is of Lemierre's syndrome diagnosed in a 21-year-old man presenting with a 5-day history of sore throat, fever, right-sided pleuritic chest pain and bilateral pulmonary nodules on CT imaging. Fusobacterium necrophorum cultured from peripheral blood and an occluded left internal jugular vein on ultrasound lead to an eventual diagnosis. Our second case presents a 29-year-old woman with a 5-day history of sore throat, fever and right-sided pleuritic chest pain. A left-sided quinsy was diagnosed and aspirated and the patient was discharged home. She represented shortly with worsening pleuritic pain and was found to have a right-sided pleural effusion with descending mediastinitis originating from the tonsillar abscess. Delayed diagnosis resulted in open thoracotomy, decortication and prolonged intravenous antibiotics. PMID:23632177

Wahab, Dalia; Bichard, Julia; Shah, Anand; Mann, Bhupinder

2013-01-01

115

Early tracheal stenosis causing extubation failure and prolonged ventilator dependency.  

PubMed

Postintubation stenosis is the most frequent cause of benign tracheal stenosis and may cause reintubation and delay in weaning of intensive care unit patients. This case study describes typical patients with tracheal stenosis and the management of these patients. Five patients requiring reintubation and mechanical ventilation due to early intubation-related stenosis are discussed. Stridor developed in three cases after extubation. In these cases, bronchoscopy revealed tracheal stenosis. Dilatation and silicone stent placement were performed using rigid bronchoscopy. The other two patients were on ventilators when they were admitted to the intensive care unit and their stenoses were also treated by rigid bronchoscopy. Hypercapnia and hypoxia resolved after intervention in three cases. Of the remaining two patients, one had the tracheostomy closed and in the other patient ventilation was stopped but the tracheostomy was maintained. Tracheal stenosis developing in the subglottic region after extubation, especially after exposure to cuff pressure, may lead to reintubation. A tracheostomy may hinder the diagnosis of progressive stenosis and may lead to unnecessary maintenance of ventilator treatment. Early intubation-related tracheal stenosis should therefore be considered in cases of weaning or extubation failure and prompt appropriate investigation and treatment. PMID:23362899

Dalar, L; Schuurmans, M M; Eryuksel, E; Karasulu, L; Kosar, A F; Altin, S

2013-01-01

116

Recurrent respiratory distress and cardiopulmonary arrest caused by megaoesophagus secondary to achalasia?  

PubMed Central

INTRODUCTION Respiratory distress and arrest from tracheal compression secondary to megaoesophagus are rare complications of achalasia. We present the case of a man with end-stage achalasia who required oesophagectomy to prevent recurrent life-threatening tracheal compression and respiratory arrest. A literature review is also presented. PRESENTATION OF CASE A 40-year old man presented with post-prandial stridor which resolved spontaneously, later being diagnosed with achalasia. He underwent pneumatic dilatation year later, intended as definitive treatment. Despite intervention, the patient had developed megaoesophagus. One month later he presented with tracheal compression and cardiorespiratory arrest but was successfully resuscitated. He subsequently underwent elective oesophagectomy. DISCUSSION Over 40 case reports of achalasia presenting with stridor have been published. However, only three cases (all female, age range, 35–79 years old) of cardiac, respiratory or cardiorespiratory arrest have been published. The definitive treatments received by these patients were botulinum toxin injections, open Heller cardiomyotomy with Dor fundoplication and pneumatic dilatation. None of these patients suffered recurrent respiratory distress following definitive treatment. The patient currently reported was unique as he suffered cardiorespiratory arrest following an intended definitive treatment, pneumatic dilatation. As such oesophagectomy was considered the greatest risk-reduction intervention. CONCLUSION Oesophagectomy should be considered for patients with end-stage achalasia and mega-oesophagus causing respiratory compromise to avoid potential fatal complications such as tracheal compression and subsequent respiratory arrest. PMID:25128729

Mabvuure, Nigel Tapiwa; Hey, Shi Ying; Forshaw, Matthew

2014-01-01

117

Rapid diagnosis of amniotic fluid embolism causing severe pulmonary failure  

Microsoft Academic Search

We report an amniotic fluid embolism in a 28-year-old woman developing 8 h after elective cesarian section. She presented with severe respiratory distress syndrome. Amniotic cells were demonstrated in central venous blood and in the endotracheal aspirate.

B. Ricou; P. Reper; P. M. Suter

1989-01-01

118

Congenital respiratory epithelial cysts of the orbit: a rare cause of major orbital impairment.  

PubMed

Congenital respiratory epithelial cysts of the orbit are rare lesions with few reported cases. Extensive disease may cause an orbital apex syndrome, resulting in significant visual loss. Two such cases were described, the risk factors associated with surgical morbidity were identified, and the embryological origins of these cysts were reviewed. PMID:24759289

Tay, Eugene; Yee, Anita Chan Sook; Luthert, Philip J; Rose, Geoffrey E

2014-01-01

119

WORLD TRADE CENTER FINE PARTICULATE MATTER CAUSES RESPIRATORY TRACT HYPERRESPONSIVENESS IN MICE  

EPA Science Inventory

World Trade Center Fine Particulate Matter Causes Respiratory Tract Hyperresponsiveness in Mice Stephen H. Gavett1, Najwa Haykal-Coates1, Jerry W. Highfill1, Allen D. Ledbetter1, Lung Chi Chen2, Mitchell D. Cohen2, Jack R. Harkema3, James G. Wagner3, and Daniel L. Costa1....

120

Outcome of lung cancer patients admitted to the intensive care unit with acute respiratory failure  

PubMed Central

Background: Previous studies have shown that the outcome of lung cancer patients who were admitted to the Intensive Care Unit (ICU), especially those requiring mechanical ventilation, is extremely poor. The present study was conducted in order to assess the outcome of a recent cohort of lung cancer patients admitted to the ICU with acute respiratory failure. Methods: A retrospective analysis of the medical records of 105 lung cancer patients who were admitted to the ICU between January 2008 and January 2011 was performed. Severity of illness on the first day of ICU admission was assessed using the acute physiology and chronic health evaluation (APACHE) II and the sequential organ failure assessment (SOFA) scoring systems. Associated organ failure was determined according to the Knaus criteria. Results: Eighty four (80%) patients were diagnosed with non-small cell lung cancer, 14 (13.3%) with small cell lung cancer, one patient with mesothelioma, and in the remaining 6 patients, the type of lung cancer could not be determined. Significant factors on admission were APACHE II and SOFA scores, poor performance status and severe comorbidity. During ICU stay, the main risk factors for poor outcome were the long term mechanical ventilation duration, use of vasopressors, more than two organ system failures and septic condition. The overall ICU, hospital and 6-month mortality rates were 44.7% (47/105), 56.1% (59/105) and 77.1% (81/105) respectively. Conclusions: The present data show that the medical intensive care unit outcome of lung cancer patients is improving. Further studies of patients selected to ICU admission are needed to assess long-term mortality, quality of life, ability to continue chemotherapy and economic cost. PMID:23935346

Anisoglou, S; Asteriou, C; Barbetakis, N; Kakolyris, S; Anastasiadou, G; Pnevmatikos, I

2013-01-01

121

Extracorporeal membrane oxygenation for pediatric respiratory failure: History, development and current status  

PubMed Central

Extracorporeal membrane oxygenation (ECMO) is currently used to support patients of all ages with acute severe respiratory failure non-responsive to conventional treatments, and although initial use was almost exclusively in neonates, use for this age group is decreasing while use in older children remains stable (300-500 cases annually) and support for adults is increasing. Recent advances in technology include: refinement of double lumen veno-venous (VV) cannulas to support a large range of patient size, pumps with lower prime volumes, more efficient oxygenators, changes in circuit configuration to decrease turbulent flow and hemolysis. Veno-arterial (VA) mode of support remains the predominant type used; however, VV support has lower risk of central nervous injury and mortality. Key to successful survival is implementation of ECMO before irreversible organ injury develops, unless support with ECMO is used as a bridge to transplant. Among pediatric patients treated with ECMO mortality varies by pulmonary diagnosis, underlying condition, other non-pulmonary organ dysfunction as well as patient age, but has remained relatively unchanged overall (43%) over the past several decades. Additional risk factors associated with death include prolonged use of mechanical ventilation (> 2 wk) prior to ECMO, use of VA ECMO, older patient age, prolonged ECMO support as well as complications during ECMO. Medical evidence regarding daily patient management specifically related to ECMO is scant, it usually mirrors care recommended for similar patients treated without ECMO. Linkage of the Extracorporeal Life Support Organization dataset with other databases and collaborative research networks will be required to address this knowledge deficit as most centers treat only a few pediatric respiratory failure patients each year. PMID:24701414

Maslach-Hubbard, Anna; Bratton, Susan L

2013-01-01

122

Artificial placenta--lung assist devices for term and preterm newborns with respiratory failure.  

PubMed

Respiratory insufficiency is a major cause of neonatal mortality and long-term morbidity, especially in very low birth weight infants. Today, non-invasive and mechanical ventilation are commonly accepted procedures to provide respiratory support to newborns, but they can reach their limit of efficacy. To overcome this technological plateau and further reduce mortality rates, the technology of an "artificial placenta", which is a pumpless lung assist device connected to the umbilical vessels, would serve to expand the therapeutic spectrum when mechanical ventilation becomes inadequate to treat neonates with severe respiratory insufficiency.?The first attempts to create such an artificial placenta took place more than 60 years ago. However, there has been a recent renaissance of this concept, including developments of its major components like the oxygenator, vascular access via umbilical vessels, flow control, as well as methods to achieve hemocompatibility in extracorporeal circuits. This paper gives a review of past and current development, animal experiments and human case studies of artificial placenta technology. PMID:23645582

Rochow, Niels; Chan, Emily C; Wu, Wen-I; Selvaganapathy, Ponnambalam R; Fusch, Gerhard; Berry, Leslie; Brash, John; Chan, Anthony K; Fusch, Christoph

2013-06-25

123

Non-invasive positive pressure ventilation to treat respiratory failure resulting from exacerbations of chronic obstructive pulmonary disease: Cochrane systematic review and meta-analysis  

Microsoft Academic Search

Objectives To determine the effectiveness of non›invasive positive pressure ventilation (NPPV) in the management of respiratory failure secondary to acute exacerbation of chronic obstructive pulmonary disease. Design Systematic review of randomised controlled trials that compared NPPV and usual medical care with usual medical care alone in patients admitted to hospital with respiratory failure resulting from an exacerbation of chronic obstructive

Josephine V Lightowler; Mark W Elliott

2003-01-01

124

High Prevalence of Respiratory Muscle Weakness in Hospitalized Acute Heart Failure Elderly Patients  

PubMed Central

Introduction Respiratory Muscle Weakness (RMW) has been defined when the maximum inspiratory pressure (MIP) is lower than 70% of the predictive value. The prevalence of RMW in chronic heart failure patients is 30 to 50%. So far there are no studies on the prevalence of RMW in acute heart failure (AHF) patients. Objectives Evaluate the prevalence of RMW in patients admitted because of AHF and the condition of respiratory muscle strength on discharge from the hospital. Methods Sixty-three patients had their MIP measured on two occasions: at the beginning of the hospital stay, after they had reached respiratory, hemodynamic and clinical stability and before discharge from the hospital. The apparatus and technique to measure MIP were adapted because of age-related limitations of the patients. Data on cardiac ejection fraction, ECG, brain natriuretic peptide (BNP) levels and on the use of noninvasive ventilation (NIV) were collected. Results The mean age of the 63 patients under study was 75 years. On admission the mean ejection fraction was 33% (95% CI: 31–35) and the BNP hormone median value was 726.5 pg/ml (range: 217 to 2283 pg/ml); 65% of the patients used NIV. The median value of MIP measured after clinical stabilization was -52.7 cmH2O (range: -20 to -120 cmH2O); 76% of the patients had MIP values below 70% of the predictive value. On discharge, after a median hospital stay of 11 days, the median MIP was -53.5 cmH2O (range:-20 to -150 cmH2O); 71% of the patients maintained their MIP values below 70% of the predictive value. The differences found were not statistically significant. Conclusion Elderly patients admitted with AHF may present a high prevalence of RMW on admission; this condition may be maintained at similar levels on discharge in a large percentage of these patients, even after clinical stabilization of the heart condition. PMID:25671566

Verissimo, Pedro; Timenetsky, Karina T.; Casalaspo, Thaisa Juliana André; Gonçalves, Louise Helena Rodrigues; Yang, Angela Shu Yun; Eid, Raquel Caserta

2015-01-01

125

Respiratory alkalosis  

MedlinePLUS

Alkalosis - respiratory ... leads to shortness of breath can also cause respiratory alkalosis. ... Treatment is aimed at the condition that causes respiratory alkalosis. Breathing into a paper bag -- or using ...

126

A 42-year-old farmer from Bangladesh with respiratory failure, septic arthritis, and multiple cavitating consolidations.  

PubMed

A 42-year-old man was directly admitted to the ICU with respiratory failure and hypotension. Two weeks prior and just after returning from Bangladesh, he presented to a polyclinic with fever, right knee pain, and generalized aches, for which he received oral antibiotics. He was a farmer, had diabetes, never smoked, and consumed alcohol occasionally. PMID:25091764

AlShati, Mohammed H; Joshi, Rajinder M

2014-08-01

127

Relation between Respiratory Changes in Arterial Pulse Pressure and Fluid Responsiveness in Septic Patients with Acute Circulatory Failure  

Microsoft Academic Search

In mechanically ventilated patients with acute circulatory failure related to sepsis, we investigated whether the respiratory changes in arterial pressure could be related to the effects of volume ex- pansion (VE) on cardiac index (CI). Forty patients instrumented with indwelling systemic and pulmonary artery catheters were studied before and after VE. Maximal and minimal values of pulse pressure (Pp max

FRÉDÉRIC MICHARD; SANDRINE BOUSSAT; DENIS CHEMLA; NADIA ANGUEL; ALAIN MERCAT; YVES LECARPENTIER; CHRISTIAN RICHARD; MICHAEL R. PINSKY; JEAN-LOUIS TEBOUL

2000-01-01

128

Low-Frequency Positive-Pressure Ventilation With Extracorporeal CO2 Removal in Severe Acute Respiratory Failure  

Microsoft Academic Search

Forty-three patients were entered in an uncontrolled study designed to evaluate extracorporeal membrane lung support in severe acute respiratory failure of parenchymal origin. Most of the metabolic carbon dioxide production was cleared through a low-flow venovenous bypass. To avoid lung injury from conventional mechanical ventilation, the lungs were kept \\

Luciano Gattinoni; Antonio Pesenti; Daniele Mascheroni; Roberto Marcolin; Roberto Fumagalli; Francesca Rossi; Giuliano Romagnoli; Ljli Uziel; Angelo Agostoni; Theodor Kolobow; Giorgio Damia

2010-01-01

129

Primary Cutaneous Blastomycosis as a Cause of Acute Respiratory Distress Syndrom  

PubMed Central

Blastomycosis is a fungal infection caused by Blastomyces dermatitidis. Exposure in endemic regions frequently occurs when spores in soil are disturbed and subsequently inhaled. Less commonly, primary cutaneous blastomycosis may follow after traumatic inoculation of the fungus into the skin. Most patients infected with blastomycosis are asymptomatic, but an unfortunate small number present with fulminant disease. Rarely, the infection can affect organs, such as the skin, bone, or genitourinary system. In a small percentage of cases, blastomycosis may cause acute respiratory distress syndrome, which is associated with a very high mortality rate. Increased survival rates have been shown when the clinician has a high index of suspicion and facilitates rapid evaluation and initiation of the appropriate therapy. We present a rare case of a patient presenting with primary cutaneous blastomycosis that progressed to disseminated disease causing acute respiratory distress syndrome. High clinical suspicion, prompt diagnostic testing, and therapy with amphotericin B, confirmed the diagnosis and resulted in a swift recovery. PMID:20729940

Spear, Joel B.

2009-01-01

130

Respiratory failure due to upper airway obstruction in children: use of the helmet as bridge interface.  

PubMed

Upper airway obstruction (UAO) can cause severe respiratory distress in young children by increasing inspiratory muscle load and decreasing alveolar ventilation, ultimately resulting in hypercapnia and hypoxemia which have long term negative cardiovascular effects. Although non-invasive continuous positive airway pressure (CPAP) improves gas exchange in these patients, use of conventional interfaces (nasal mask, nasal pillow and facial mask) may cause significant discomfort and lead to CPAP intolerance. We report five cases of children affected by UAO who experienced CPAP intolerance via application of conventional interfaces. Alternatively, we acutely applied helmet-CPAP which resulted in improved breathing pattern and gas exchange. Thereafter, patients received training with respect to a nasal CPAP interface, allowing successful long term treatment. In conclusion, these five clinical cases demonstrate that helmet-CPAP can be used acutely in children with UAO if compliance to conventional modalities is problematic, allowing for sufficient time to achieve compliance to nasal-CPAP. PMID:24918190

Racca, F; Cutrera, R; Robba, C; Caldarelli, V; Paglietti, M G; De Angelis, M C; Sekhon, M S; Gualino, J; Bella, C; Passoni, N; Ranieri, V M

2014-06-11

131

Heart failure caused by congenital left-sided lesions.  

PubMed

There are diverse mechanisms by which congenital left-sided cardiac lesions can precipitate heart failure. Left heart outflow obstruction can impose abnormal pressure load on the left ventricle, inducing adverse remodeling, hypertrophy, and diastolic and systolic dysfunction. Abnormalities in left ventricular inflow can increase pulmonary venous pressure and predisposing to pulmonary edema. In addition, inborn abnormalities in left ventricular myocardial structure and function can impair both systolic and diastolic function and manifest as heart failure later in life. In this article, the different mechanisms, outcomes, and treatments of heart failure in patients with congenital left-sided lesions are discussed. PMID:24275301

Krieger, Eric V; Fernandes, Susan M

2014-01-01

132

Six minute walking distance in kyphoscoliosis patients with chronic respiratory failure  

PubMed Central

Aim To evaluate kyphoscoliosis patients with chronic hypercapnic respiratory failure (CHRF) using the six minute walk test (6MWT) distance (6MWD) and cardio-pulmonary function tests. Method This prospective cross-sectional study was carried out in a tertiary training and research hospital in Turkey. Kyphoscoliosis patients with CHRF on home mechanical ventilation (HMV) followed in a respiratory intensive care unit (RICU) out-patient clinic were enrolled. Patients' demographics were recorded as well as transthoracic echocardiography (ECHO), 6MWD, spirometry, arterial blood gas (ABG) values and high resolution chest computed tomography. 6MWT results were compared with other parameters. Results Thirty four patients with kyphoscoliosis and chronic respiratory insufficiency admitted to our outpatient clinic were included in the study but 25 (17 M) patients underwent 6MWT (8 patients walked with oxygen supplement due to PaO2 < 60 mm Hg). The mean 6MWD was 274.4 ± 76.2 (median 270) m and median 6MWD predicted rate was 43.7% (inter quartile ratio, IQR, 37.6% to 47.7%). Median HMV use was 3 years (IQR 2-4). 6MWD predicted rate, body mass index (BMI), HMV duration were similar in male and female patients. 6MWD correlated well with age, BMI, dyspnea score for baseline 6MWT (r: - 0.59, p < 0.002, r: - 0.58, p < 0.003, r: - 0.55, p < 0.005 respectively) but modestly with forced expiratory volume in one second, pulse rate for baseline 6MWT, pulse saturation rate, fatigue and dyspnea score at end of 6MWT (r: - 0.44, p < 0.048; r: 0.44, p < 0.027; r: - 0.43, p < 0.031; r: - 0.42, p < 0.036; r: - 0.42, p < 0.034 respectively). 6MWD predicted rate was only correlated with dyspnea score at baseline (r: - 0.46, p < 0.022). The systolic pulmonary arterial pressure (PAPs) in 6 (24%) cases was more than 40 mmHg, in whom mean PaO2/FiO2 was 301.4 ± 55.4 compared to 280.9 ± 50.2 in those with normal PAPs (p > 0.40). Conclusion The 6MWT is an easy way to evaluate physical performance limitation in kyphoscoliosis patients with chronic hypercapnic respiratory failure using home mechanical ventilation. Nearly 275 m was the mean distance walked in the 6MWT, but rather than distance in meters, the 6MWD predicted rate according to gender and body mass index equation might be a better way for deciding about physical performance of these patients. Dyspnea score at baseline before the 6MWT may be the most important point that affects 6MWD in this patient population. PMID:22958538

2010-01-01

133

Obstructive Uropathy: An Important Cause of Chronic Renal Failure in Children  

Microsoft Academic Search

Care of individuals with renal failure continues to impose a tremendous burden on our national health care budget. Chronic renal failure is the final common denominator of a multiplicity of pathologic processes, some of which progress silently over years. Of these, obstructive uropathy is a prominent cause of kidney failure, accounting for 16.5% of all pediatric renal transplants in 1997.

Karl S. Roth; Harry P. Koo; Stephanie E. Spottswood; James Cm Chan

2002-01-01

134

Respiratory Infections Cause the Release of Extracellular Vesicles: Implications in Exacerbation of Asthma/COPD  

PubMed Central

Background Infection-related exacerbations of respiratory diseases are a major health concern; thus understanding the mechanisms driving them is of paramount importance. Despite distinct inflammatory profiles and pathological differences, asthma and COPD share a common clinical facet: raised airway ATP levels. Furthermore, evidence is growing to suggest that infective agents can cause the release of extracellular vesicle (EVs) in vitro and in bodily fluids. ATP can evoke the P2X7/caspase 1 dependent release of IL-1?/IL-18 from EVs; these cytokines are associated with neutrophilia and are increased during exacerbations. Thus we hypothesized that respiratory infections causes the release of EVs in the airway and that the raised ATP levels, present in respiratory disease, triggers the release of IL-1?/IL-18, neutrophilia and subsequent disease exacerbations. Methods To begin to test this hypothesis we utilised human cell-based assays, ex vivo murine BALF, in vivo pre-clinical models and human samples to test this hypothesis. Results Data showed that in a murine model of COPD, known to have increased airway ATP levels, infective challenge causes exacerbated inflammation. Using cell-based systems, murine models and samples collected from challenged healthy subjects, we showed that infection can trigger the release of EVs. When exposed to ATP the EVs release IL-1?/IL-18 via a P2X7/caspase-dependent mechanism. Furthermore ATP challenge can cause a P2X7 dependent increase in LPS-driven neutrophilia. Conclusions This preliminary data suggests a possible mechanism for how infections could exacerbate respiratory diseases and may highlight a possible signalling pathway for drug discovery efforts in this area. PMID:24972036

Eltom, Suffwan; Dale, Nicole; Raemdonck, Kristof R. G.; Stevenson, Christopher S.; Snelgrove, Robert J.; Sacitharan, Pradeep K.; Recchi, Chiara; Wavre-Shapton, Silene; McAuley, Daniel F.; O'Kane, Cecilia; Belvisi, Maria G.; Birrell, Mark A.

2014-01-01

135

Newly discovered coronavirus as the primary cause of severe acute respiratory syndrome  

Microsoft Academic Search

Summary Background The worldwide outbreak of severe acute respiratory syndrome (SARS) is associated with a newly discovered coronavirus, SARS-associated coronavirus (SARS- CoV). We did clinical and experimental studies to assess the role of this virus in the cause of SARS. Methods We tested clinical and postmortem samples from 436 SARS patients in six countries for infection with SARS- CoV, human

Thijs Kuiken; Ron A M Fouchier; Martin Schutten; Guus F Rimmelzwaan; Geert van Amerongen; Debby van Riel; Jon D Laman; Ton de Jong; Gerard van Doornum; Wilina Lim; Ai Ee Ling; Paul K S Chan; John S Tam; Maria C Zambon; Robin Gopal; Christian Drosten; Sylvie van der Werf; Nicolas Escriou; Jean-Claude Manuguerra; Klaus Stöhr; J S Malik Peiris; Albert D M E Osterhaus

136

Extracorporeal membrane oxygenation in adult patients with hematologic malignancies and severe acute respiratory failure  

PubMed Central

Introduction Acute respiratory failure (ARF) is the main reason for intensive care unit (ICU) admissions in patients with hematologic malignancies (HMs). We report the first series of adult patients with ARF and HMs treated with extracorporeal membrane oxygenation (ECMO). Methods This is a retrospective cohort study of 14 patients with HMs (aggressive non-Hodgkin lymphoma (NHL) n?=?5; highly aggressive NHL, that is acute lymphoblastic leukemia or Burkitt lymphoma, n?=?5; Hodgkin lymphoma, n?=?2; acute myeloid leukemia, n?=?1; multiple myeloma, n?=?1) receiving ECMO support because of ARF (all data as medians and interquartile ranges; age, 32 years (22 to 51 years); simplified acute physiology score II (SAPS II): 51 (42 to 65)). Etiology of ARF was pneumonia (n?=?10), thoracic manifestation of NHL (n?=?2), sepsis of nonpulmonary origin (n?=?1), and transfusion-related acute lung injury (n?=?1). Diagnosis of HM was established during ECMO in four patients, and five first received (immuno-) chemotherapy on ECMO. Results Before ECMO, the PaO2/FiO2 ratio was 60 (53 to 65), (3.3 to 3.7). Three patients received venoarterial ECMO because of acute circulatory failure in addition to ARF; all other patients received venovenous ECMO. All patients needed vasopressors, and five needed hemofiltration. Thrombocytopenia occurred in all patients (lowest platelet count was 20 (11 to 21) G/L). Five major bleeding events were noted. ECMO duration was 8.5 (4 to 16) days. ICU and hospital survival was 50%. All survivors were alive at follow-up (36 (10 to 58) months); five patients were in complete remission, one in partial remission, and one had relapsed. Conclusions ECMO therapy is feasible in selected patients with HMs and ARF and can be associated with long-term disease-free survival. PMID:24443905

2014-01-01

137

Spinal anaesthesia for caesarean section in the presence of respiratory failure and spinal metastases from a soft tissue clear cell sarcoma.  

PubMed

Spinal metastases occur in up to 70% of all patients with cancer. However, only 10% are symptomatic. Before considering central neuraxial blockade in patients with malignancy, a history of back pain should be excluded. Anaesthetists should be aware that intrathecal and epidural injections could cause paraplegia if metastases are impinging on the spinal cord. Failure to achieve adequate sensory anaesthesia after central neuraxial blockade or presentation with postoperative paraplegia may indicate the presence of asymptomatic vertebral canal metastases. In this report, the anaesthetic management of a patient with respiratory failure and spinal metastases from a soft tissue sarcoma, requiring caesarean section is described. Sensory anaesthesia extending above a level of imminent cord compression was achieved despite loss of cerebrospinal fluid signal on magnetic resonance imaging. PMID:23809016

Miskovic, A M; Dob, D P

2013-07-01

138

Increased left ventricular stiffness impairs filling in dogs with pulmonary emphysema in respiratory failure.  

PubMed Central

In a chronic canine model of pulmonary emphysema, we studied the interaction between left ventricular (LV) mechanics and pulmonary disease during severe hypoxemia. The hypoxemia was similar to that which may occur during a severe exacerbation of chronic obstructive lung disease. In six dogs with papain-induced emphysema and in seven dogs without emphysema, LV mechanics were examined when a hypoxic gas mixture was inspired to reduce PO2 to about 35 mmHg (hypoxic study) and during nonhypoxic conditions (room air study). In both groups, LV diastolic compliance was reduced during the hypoxic study by a similar amount. This finding could not be explained in terms of ventricular interdependence. Our analysis suggested that hypoxia decreased diastolic compliance (i.e., increased LV diastolic stiffness) by impairing LV relaxation. The primary effect of hypoxia was to decrease the extent to which LV relaxation occurred for a given end-diastolic pressure, while the rate of LV relaxation was decreased just slightly. This study indicates that severe hypoxemia because of respiratory failure may impair myocardial relaxation leading to a decrease in LV filling. PMID:3722377

Gomez, A; Mink, S

1986-01-01

139

Morphological response to positive end expiratory pressure in acute respiratory failure. Computerized tomography study.  

PubMed

Ten patients with acute respiratory failure (ARF), (4 pneumonia, 4 sepsis, 2 polytrauma), underwent computerized tomography (CT) of the lungs, (apex, hilum, base), at 5, 10, 15 cm H2O positive end expiratory pressure (PEEP). The ARF lungs, on CT scan, appeared as a patchwork of normal and dense areas with generally well defined boundaries. Most of the densities were found in the dependent regions. The areas of density were correlated with PaO2 (r = 0.51). The PEEP increase resulted in a significant expansion of total cross-sectional lung surface area. The dense areas decreased significantly at the hilum and base when increasing PEEP while the changes at the apex were not significant. The changes of density with PEEP were highly correlated with the changes in oxygenation (r = 0.91). In the individual patient, however, the modifications of gas exchange can not be entirely predicted from morphological changes, possibly due to a diversion of pulmonary blood flow. PMID:3525633

Gattinoni, L; Mascheroni, D; Torresin, A; Marcolin, R; Fumagalli, R; Vesconi, S; Rossi, G P; Rossi, F; Baglioni, S; Bassi, F

1986-01-01

140

Body position changes redistribute lung computed-tomographic density in patients with acute respiratory failure.  

PubMed

Ten patients with parenchymal acute respiratory failure (ARF) underwent computed tomography (CT) scans while in the supine and prone positions. At equal levels of positive end-expiratory pressure, the authors measured the changes of CT density in dorsal and ventral basilar lung regions induced by the change of position as well as alterations of gas exchange. The level of venous admixture did not change with body position. The CT scan image of each lung was fractionated into ten levels from dorsal to ventral, each constituting 10% of the lung height. After measuring each lung fraction, the volume, the average CT number, its frequency distribution, and the expected normal value, we computed the lung tissue mass, the excess tissue mass, and the fraction of normally inflated tissue (excess tissue mass = amount of "tissue," which includes edema, cells, and blood in excess of the expected normal value). We also estimated the superimposed hydrostatic pressure on each lung region. We found that the excess lung tissue mass is independent of position. However, in patients in the supine position, lung CT density increased and regional inflation decreased from ventral to dorsal, suggesting progressive deflation of gas-containing alveoli along the gravity gradient. A similar ventral-dorsal deflation pattern occurred within 10 min in patients in the prone position. We conclude that the lung in patients with ARF behaves like an elastic body with a diffusely increased mass; dependent lung regions are compressed by the pressure of overlying structures.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1986640

Gattinoni, L; Pelosi, P; Vitale, G; Pesenti, A; D'Andrea, L; Mascheroni, D

1991-01-01

141

Renal Failure Caused by Malakoplakia Lesions of the Urinary Bladder  

PubMed Central

?alakoplakia is a rare inflammatory condition of the urogenital tract. The most frequently affected organ is urinary bladder. This condition has features of a granulomatous inflammation, the pathogenesis of which is not well understood. In this study, we presented a case of urinary bladder malakoplakia associated with advanced obstructive uropathy and renal failure.

Stamatiou, Konstantinos; Chelioti, Eleni; Tsavari, Aikaterini; Koulia, Kalliroi; Papalexandrou, Alexia; Efthymiou, Evdokia; Tsilivigkou, Maria; Vasilakaki, Thivi

2014-01-01

142

Endomyocardial nodular calcification as a cause of heart failure.  

PubMed

Massive cardiac calcification is rare, occurring in association with chronic diseases or more commonly with previous myocardial infarction. We present an intriguing case of massive myocardial calcification of the left ventricle in a young patient with restrictive cardiomyopathy and progressive heart failure who required transplantation. The patient's history and clinical presentation did not reveal the etiology of the myocardial calcification. PMID:20952214

Segura, Ana Maria; Radovancevic, Rajko; Connelly, John H; Loyalka, Pranav; Gregoric, Igor D; Buja, L Maximillian

2011-01-01

143

Respiratory depression caused by either morphine microinjection or repetitive electrical stimulation in the region of the nucleus parabrachialis of cats  

Microsoft Academic Search

In chloralose-urethane anesthetized, vagotomized, paralyzed and artificially ventilated cats, respiratory response to either repetitive electrical stimulation or micro-injection of morphine in the rostral pons was studied by recording the phrenic nerve discharges. In the region of the nucleus parabrachialis (PBN) and its ventral reticular formation, electrical stimulation delivered in 20 successive expiratory periods caused the respiratory depression to last long

Kunihiro Eguchi; Eiko Tadaki; Dante Simbulan Jr; Takao Kumazawa

1987-01-01

144

Imaging Features of Cervical Lymphangiomas As A Cause of Respiratory Distress and Vascular-Lymphatic Disturbance  

PubMed Central

Objective Our aim is to present the imaging features of cervical lymphangiomas, which may be related with respiratory and vascular disturbances. Materials and Methods. Nine patients with cervical lymphangioma were evaluated with ultrasound (US), computed tomography (CT), and/or magnetic resonance imaging (MRI). While one case was a fetus in the second trimester, eight cases with tracheal stenosis were neonates or in childhood. Results One case was diagnosed in utero with US. All lymphangiomas were hypoechoic on the US and were of low-density (20–25 HU) on the CT. They showed a heterogeneous hypo- or hyperintense signal on T1-weighted MR images and a heterogeneous hyperintense signal on T2-weighted images. Upon contrast-enhanced CT and MR imaging, mild contrast enhancements were detected, particularly on the thick septations. Conslusion. Cervical lymphangiomas present as cystic lesions with septations, and they may cause respiratory distress or vascular-lymphatic disturbance.

Eren, Suat; Bakir, Zeki

2009-01-01

145

Guillain-Barré syndrome in two patients with respiratory failure and a review of the Japanese literature  

PubMed Central

We described two patients with Guillain-Barré syndrome and respiratory failure with or without mechanical ventilation. Case 1 was a 44-year-old man who treated as pneumonia under mechanical ventilation for a month and transferred to our hospital with unsuccessful weaning trials because of phrenic nerve palsy. Case 2 was a 74-year-old man who presented with aspiration pneumonia because of bulbar palsy. The present two cases with review of the Japanese literature showed that antecedent infection with initial symptoms within the most recent 5 to 46 days is a clinical clue to the diagnosis even in patients with Guillain-Barré syndrome accompanied by respiratory failure. PMID:23205285

Sohara, Erei; Saraya, Takeshi; Honda, Kojiro; Yamada, Atsuko; Inui, Toshiya; Ogawa, Yukari; Sada, Mitsuru; Tsujimoto, Naoki; Nakamura, Masuo; Tsuchiya, Akiko; Saito, Masaki; Oishi, Chizuko; Chiba, Atsuro; Takizawa, Hajime

2012-01-01

146

Paraphenylene diamine ingestion: an uncommon cause of acute renal failure.  

PubMed

Paraphenylene diamine (PPD) is a major component of hair dyes. The aim is to study the renal manifestations and outcome of PPD consumption. During a four-year period from 2002 to February 2006, 10 persons were admitted to our Institute after consuming a hair dye in a suicidal bid. The percentage of ARF due to PPD at our Institute was 0.95%. Seven patients out of 10 (70%) who consumed PPD developed ARF. All 10 patients, including the patients who had normal renal function had features of rhabdomyolysis. Two patients required ventilator support for respiratory distress and two more required tracheostomy due to upper airway tract edema. One patient has expired after two sessions of dialysis. Renal biopsy in two patients (one, postmortem) showed acute tubular necrosis along with presence of casts in tubules due to myoglobin. PMID:17699992

Ram, R; Swarnalatha, G; Prasad, N; Dakshinamurty, K V

2007-01-01

147

World Trade Center fine particulate matter causes respiratory tract hyperresponsiveness in mice.  

PubMed Central

Pollutants originating from the destruction of the World Trade Center (WTC) in New York City on 11 September 2001 have been reported to cause adverse respiratory responses in rescue workers and nearby residents. We examined whether WTC-derived fine particulate matter [particulate matter with a mass median aerodynamic diameter < 2.5 microm (PM2.5)] has detrimental respiratory effects in mice to contribute to the risk assessment of WTC-derived pollutants. Samples of WTC PM2.5 were derived from settled dust collected at several locations around Ground Zero on 12 and 13 September 2001. Aspirated samples of WTC PM2.5 induced mild to moderate degrees of pulmonary inflammation 1 day after exposure but only at a relatively high dose (100 microg). This response was not as great as that caused by 100 microg PM2.5 derived from residual oil fly ash (ROFA) or Washington, DC, ambient air PM [National Institute of Standards and Technology, Standard Reference Material (SRM) 1649a]. However, this same dose of WTC PM2.5 caused airway hyperresponsiveness to methacholine aerosol comparable to that from SRM 1649a and to a greater degree than that from ROFA. Mice exposed to lower doses by aspiration or inhalation exposure did not develop significant inflammation or hyperresponsiveness. These results show that exposure to high levels of WTC PM2.5 can promote mechanisms of airflow obstruction in mice. Airborne concentrations of WTC PM2.5 that would cause comparable doses in people are high (approximately 425 microg/m3 for 8 hr) but conceivable in the aftermath of the collapse of the towers when rescue and salvage efforts were in effect. We conclude that a high-level exposure to WTC PM2.5 could cause pulmonary inflammation and airway hyperresponsiveness in people. The effects of chronic exposures to lower levels of WTC PM2.5, the persistence of any respiratory effects, and the effects of coarser WTC PM are unknown and were not examined in these studies. Degree of exposure and respiratory protection, individual differences in sensitivity to WTC PM2.5, and species differences in responses must be considered in assessing the risks of exposure to WTC PM2.5. PMID:12782502

Gavett, Stephen H; Haykal-Coates, Najwa; Highfill, Jerry W; Ledbetter, Allen D; Chen, Lung Chi; Cohen, Mitchell D; Harkema, Jack R; Wagner, James G; Costa, Daniel L

2003-01-01

148

Inhalation of Ortho-Phthalaldehyde Vapor Causes Respiratory Sensitization in Mice  

PubMed Central

Ortho-Phthalaldehyde (OPA) has been approved for high-level sterilization of heat-sensitive medical instruments and is increasingly being used as a replacement in the healthcare industry for glutaraldehyde, a known sensitizer. Numerous case reports have been published indicating workers and patients experiencing respiratory problems, anaphylaxis, skin reactivity, and systemic antibody production. Our laboratory previously demonstrated that OPA is a dermal sensitizer in mice. The goal of the present study was to determine if OPA is a respiratory sensitizer following inhalation exposure. Mice were exposed to OPA vapor and airway and lymph nodes were examined for cytokine gene expression and alterations in lymphocyte populations. Inhalation of OPA for 3 days resulted in a concentration-dependent increase in lymphocyte proliferation, mainly B lymphocytes, in the draining lymph nodes. A secondary challenge of mice with OPA resulted in a dramatic increase in the population of B lymphocytes expressing IgE. Expression of Th2 (IL-4, IL-5, and IL-13) and anti/proinflammatory (IL-10, TNF?, and IL-1?) cytokine genes was upregulated in the lymph nodes and the nasal mucosa. Mice exposed to the higher concentrations of OPA-produced OPA-specific IgG1 antibodies indicating systemic sensitization. These findings provide evidence that OPA has the potential to cause respiratory sensitization in mice. PMID:21785612

Johnson, Victor J.; Reynolds, Jeffrey S.; Wang, Wei; Fluharty, Kara; Yucesoy, Berran

2011-01-01

149

Inhalation of ortho-phthalaldehyde vapor causes respiratory sensitization in mice.  

PubMed

Ortho-Phthalaldehyde (OPA) has been approved for high-level sterilization of heat-sensitive medical instruments and is increasingly being used as a replacement in the healthcare industry for glutaraldehyde, a known sensitizer. Numerous case reports have been published indicating workers and patients experiencing respiratory problems, anaphylaxis, skin reactivity, and systemic antibody production. Our laboratory previously demonstrated that OPA is a dermal sensitizer in mice. The goal of the present study was to determine if OPA is a respiratory sensitizer following inhalation exposure. Mice were exposed to OPA vapor and airway and lymph nodes were examined for cytokine gene expression and alterations in lymphocyte populations. Inhalation of OPA for 3 days resulted in a concentration-dependent increase in lymphocyte proliferation, mainly B lymphocytes, in the draining lymph nodes. A secondary challenge of mice with OPA resulted in a dramatic increase in the population of B lymphocytes expressing IgE. Expression of Th2 (IL-4, IL-5, and IL-13) and anti/proinflammatory (IL-10, TNF?, and IL-1?) cytokine genes was upregulated in the lymph nodes and the nasal mucosa. Mice exposed to the higher concentrations of OPA-produced OPA-specific IgG(1) antibodies indicating systemic sensitization. These findings provide evidence that OPA has the potential to cause respiratory sensitization in mice. PMID:21785612

Johnson, Victor J; Reynolds, Jeffrey S; Wang, Wei; Fluharty, Kara; Yucesoy, Berran

2011-01-01

150

Etiological factors causing lower respiratory tract infections isolated from hospitalized patients.  

PubMed

Lower respiratory tract infections (LRTI) account for 20-30 % of all hospital-acquired contagions. They are characterized by high mortality of hospitalized patients. The most serious form of LRTI is pneumonia, and the most common etiological factors in such cases are bacteria. The article gives the analysis of bacterial flora samples obtained from lower respiratory tract of hospitalized patients. In vitro susceptibility of pathogens to selected antibiotics has also been assessed. We carried out a retrospective analysis of 1,171 bacterial strains isolated from 1,171 patients treated in clinics of the Military Institute of Medicine in Warsaw, Poland. In most cases the samples were collected from an endotracheal or tracheostomic tube (71.5 %) and from bronchoalveolar lavage (21.7 %). The most commonly isolated pathogens included Acinetobacter baumannii (35.8 %), Staphylococcus aureus (27.6 %), Klebsiella pneumoniae (19.4 %), and Pseudomonas aeruginosa (16.2 %). Multidrug-resistant gram-negative bacteria exhibited 100 % susceptibility to colistin only. Klebsiella pneumoniae ESBL+ and Acinetobacter baumannii were most susceptible to carbapenems, while Pseudomonas aeruginosa strains to ceftazidime. Methicillin-resistant Staphylococcus aureus were 100 % susceptible to vancomycin, linezolid, and tigecycline. In conclusion, identifying the etiological factors causing infections of the lower respiratory tract and determining their drug-susceptibility is of key importance in empirical treatment. PMID:25310945

Guzek, A; Rybicki, Z; Korzeniewski, K; Mackiewicz, K; Saks, E; Chcia?owski, A; Zwoli?ska, E

2015-01-01

151

Exhaled nitric oxide in neonates with or without hypoxemic respiratory failure  

PubMed Central

BACKGROUND: Exhaled nitric oxide (eNO) is one of the airway condensate derived markers, reflecting mainly airway inflammation in asthma and other lung diseases. The changes of eNO levels as pathophysiology of neonatal hypoxemic respiratory failure (HRF) in early postnatal life have not been thoroughly studied. The present study was to establish a method for measuring eNO concentrations in neonates with or without HRF. METHODS: Twenty-two newborn infants with HRF and 26 non-NRF controls were included within the first 24 hours of postnatal life. Their eNO levels were detected with a rapid-response chemiluminescence analyzer daily during the first week of their postnatal life, and lung mechanics and gas exchange efficiency were monitored at the same time, such as pulse oxygen saturation (SpO2), inspired fraction of oxygen (FiO2) and other parameters. RESULTS: During the first two days of postnatal life, eNO values of HRF neonates were significantly higher than those of the control neonates (day 1, 7.9±3.2 vs. 5.8±1.8 parts per billion [ppb], P<0.05; day 2, 8.8±3.2 vs. 6.0±2.4 ppb, P<0.05), but there were no significant differences in the following days. With SpO2/FiO2 increasing, difference of eNO values between the HRF and non-HRF neonates became narrowed, but there was still a two-fold difference of eNO/[SpO2/(FiO2×100)] on days 5-7. CONCLUSION: We established a method for measuring eNO and found difference in neonates with or without HRF, which diminished with prolonged postnatal days, reflecting pathophysiological characteristics of HRF. PMID:25215009

Liu, Li-juan; Gao, Xi-rong; Wu, Pan-pan; Qian, Li-ling; Chen, Chao; Sun, Bo

2011-01-01

152

[Ultrastructural changes in middle ear and cochlea caused by respiratory syncytial virus in guinea pigs].  

PubMed

Respiratory syncytial virus (RSV) was inoculated into the middle ear of guinea pigs. Preyer's reflex began to decrease since 21st day. The positive rate of RSV culture from middle ear mucosa within the first week was 50%. The titer of IgG antibody against RSV in sera rose gradually. Electron microscopy showed enlarged rough endoplasmic reticulum, swelling mitochondria and pyknosis of nuclei in the epithelial and mononuclear cells of middle ear. The surface of Corti's organ was covered with exudate; hair cells had their hairs distorted or desquamated. The results indicate that the RSV can cause acute infection of middle ear and degeneration of hair cells of the cochlea. PMID:2076325

Zhong, G Y

1990-08-01

153

Implementing hospital-based surveillance for severe acute respiratory infections caused by influenza and other respiratory pathogens in New Zealand  

PubMed Central

Background Recent experience with pandemic influenza A(H1N1)pdm09 highlighted the importance of global surveillance for severe respiratory disease to support pandemic preparedness and seasonal influenza control. Improved surveillance in the southern hemisphere is needed to provide critical data on influenza epidemiology, disease burden, circulating strains and effectiveness of influenza prevention and control measures. Hospital-based surveillance for severe acute respiratory infection (SARI) cases was established in New Zealand on 30 April 2012. The aims were to measure incidence, prevalence, risk factors, clinical spectrum and outcomes for SARI and associated influenza and other respiratory pathogen cases as well as to understand influenza contribution to patients not meeting SARI case definition. Methods/Design All inpatients with suspected respiratory infections who were admitted overnight to the study hospitals were screened daily. If a patient met the World Health Organization’s SARI case definition, a respiratory specimen was tested for influenza and other respiratory pathogens. A case report form captured demographics, history of presenting illness, co-morbidities, disease course and outcome and risk factors. These data were supplemented from electronic clinical records and other linked data sources. Discussion Hospital-based SARI surveillance has been implemented and is fully functioning in New Zealand. Active, prospective, continuous, hospital-based SARI surveillance is useful in supporting pandemic preparedness for emerging influenza A(H7N9) virus infections and seasonal influenza prevention and control. PMID:25077034

Baker, Michael; McArthur, Colin; Roberts, Sally; Williamson, Deborah; Grant, Cameron; Trenholme, Adrian; Wong, Conroy; Taylor, Susan; LeComte, Lyndsay; Mackereth, Graham; Bandaranayake, Don; Wood, Tim; Bissielo, Ange; Se, Ruth; Turner, Nikki; Pierse, Nevil; Thomas, Paul; Webby, Richard; Gross, Diane; Duque, Jazmin; Thompson, Mark; Widdowson, Marc-Alain

2014-01-01

154

Total liquid ventilation provides superior respiratory support to conventional mechanical ventilation in a large animal model of severe respiratory failure.  

PubMed

Total liquid ventilation (TLV) has the potential to provide respiratory support superior to conventional mechanical ventilation (CMV) in the acute respiratory distress syndrome (ARDS). However, laboratory studies are limited to trials in small animals for no longer than 4 hours. The objective of this study was to compare TLV and CMV in a large animal model of ARDS for 24 hours. Ten sheep weighing 53 ± 4 (SD) kg were anesthetized and ventilated with 100% oxygen. Oleic acid was injected into the pulmonary circulation until PaO2:FiO2 ? 60 mm Hg, followed by transition to a protective CMV protocol (n = 5) or TLV (n = 5) for 24 hours. Pathophysiology was recorded, and the lungs were harvested for histological analysis. Animals treated with CMV became progressively hypoxic and hypercarbic despite maximum ventilatory support. Sheep treated with TLV maintained normal blood gases with statistically greater PO2 (p < 10(-9)) and lower PCO2 (p < 10(-3)) than the CMV group. Survival at 24 hours in the TLV and CMV groups were 100% and 40%, respectively (p < 0.05). Thus, TLV provided gas exchange superior to CMV in this laboratory model of severe ARDS. PMID:21084968

Pohlmann, Joshua R; Brant, David O; Daul, Morgan A; Reoma, Junewai L; Kim, Anne C; Osterholzer, Kathryn R; Johnson, Kent J; Bartlett, Robert H; Cook, Keith E; Hirschl, Ronald B

2011-01-01

155

A general cause based methodology for analysis of dependent failures in system risk and reliability assessments  

NASA Astrophysics Data System (ADS)

Traditional parametric Common Cause Failure (CCF) models quantify the soft dependencies between component failures through the use of empirical ratio relationships. Furthermore CCF modeling has been essentially restricted to identical components in redundant formations. While this has been advantageous in allowing the prediction of system reliability with little or no data, it has been prohibitive in other applications such as modeling the characteristics of a system design or including the characteristics of failure when assessing the risk significance of a failure or degraded performance event (known as an event assessment). This dissertation extends the traditional definition of CCF to model soft dependencies between like and non-like components. It does this through the explicit modeling of soft dependencies between systems (coupling factors) such as sharing a maintenance team or sharing a manufacturer. By modeling the soft dependencies explicitly these relationships can be individually quantified based on the specific design of the system and allows for more accurate event assessment given knowledge of the failure cause. Since the most data informed model in use is the Alpha Factor Model (AFM), it has been used as the baseline for the proposed solutions. This dissertation analyzes the US Nuclear Regulatory Commission's Common Cause Failure Database event data to determine the suitability of the data and failure taxonomy for use in the proposed cause-based models. Recognizing that CCF events are characterized by full or partial presence of "root cause" and "coupling factor" a refined failure taxonomy is proposed which provides a direct link between the failure cause category and the coupling factors. This dissertation proposes two CCF models (a) Partial Alpha Factor Model (PAFM) that accounts for the relevant coupling factors based on system design and provide event assessment with knowledge of the failure cause, and (b)General Dependency Model (GDM),which uses Bayesian Network to model the soft dependencies between components. This is done through the introduction of three parameters for each failure cause that relate to component fragility, failure cause rate, and failure cause propagation probability.

O'Connor, Andrew N.

156

Probable chronic renal failure caused by Lonomia caterpillar envenomation.  

PubMed

Erucism is a skin reaction to envenomation from certain poisonous caterpillar bristles. In Brazil, most reports of erucism provoked by Lonomia caterpillars are from the southern region. Most manifestations of erucism are local and include burning pain, itching, local hyperthermia and, rarely, blisters (benign symptoms with spontaneous regression in a few hours). General symptoms such as nausea and vomiting, headache, fever, myalgia, abdominal pain and conjunctivitis may also occur. Uncommon symptoms include arthritis, coagulation disorders (manifested as bruising and bleeding), intracerebral hemorrhage and acute renal failure, which comprise serious complications. The present study reports the case of 60-year-old patient from Rio de Janeiro state, Brazil, who came into contact with a caterpillar and developed, a few days later, chronic renal disease. PMID:23849585

Schmitberger, Poliana Abrantes; Fernandes, Tássia Clara; Santos, Robson Corrêa; de Assis, Rafael Campos; Gomes, Andréia Patrícia; Siqueira, Priscila Karina; Vitorino, Rodrigo Roger; de Mendonça, Eduardo Gomes; de Almeida Oliveira, Maria Goreti; Siqueira-Batista, Rodrigo

2013-01-01

157

Probable chronic renal failure caused by Lonomia caterpillar envenomation  

PubMed Central

Erucism is a skin reaction to envenomation from certain poisonous caterpillar bristles. In Brazil, most reports of erucism provoked by Lonomia caterpillars are from the southern region. Most manifestations of erucism are local and include burning pain, itching, local hyperthermia and, rarely, blisters (benign symptoms with spontaneous regression in a few hours). General symptoms such as nausea and vomiting, headache, fever, myalgia, abdominal pain and conjunctivitis may also occur. Uncommon symptoms include arthritis, coagulation disorders (manifested as bruising and bleeding), intracerebral hemorrhage and acute renal failure, which comprise serious complications. The present study reports the case of 60-year-old patient from Rio de Janeiro state, Brazil, who came into contact with a caterpillar and developed, a few days later, chronic renal disease. PMID:23849585

2013-01-01

158

Respiratory Viral Infections in Infants: Causes, Clinical Symptoms, Virology, and Immunology  

PubMed Central

Summary: In global terms, respiratory viral infection is a major cause of morbidity and mortality. Infancy, in particular, is a time of increased disease susceptibility and severity. Early-life viral infection causes acute illness and can be associated with the development of wheezing and asthma in later life. The most commonly detected viruses are respiratory syncytial virus (RSV), rhinovirus (RV), and influenza virus. In this review we explore the complete picture from epidemiology and virology to clinical impact and immunology. Three striking aspects emerge. The first is the degree of similarity: although the infecting viruses are all different, the clinical outcome, viral evasion strategies, immune response, and long-term sequelae share many common features. The second is the interplay between the infant immune system and viral infection: the immaturity of the infant immune system alters the outcome of viral infection, but at the same time, viral infection shapes the development of the infant immune system and its future responses. Finally, both the virus and the immune response contribute to damage to the lungs and subsequent disease, and therefore, any prevention or treatment needs to address both of these factors. PMID:20065326

Tregoning, John S.; Schwarze, Jürgen

2010-01-01

159

PATHOGENICITY OF IBDV RELATED TO OUTBREAKS IN THE VACCINATED FLOCKS AND THE CAUSES OF VACCINATION FAILURE  

Microsoft Academic Search

Islam M. N., Rashid S. M. H., Hoque M. F., Juli M. S. B. and Khatun M. 2008. Pathogenicity of IBDV Related to Outbreaks in the Vaccinated Flocks and the Causes of Vaccination Failure. j. innov.dev.strategy 2(3): 22-30 Pathogenicity of infectious bursal disease virus (IBDV) related to the outbreaks in the vaccinated flocks and the probable causes of vaccination failure

M. N. ISLAM; S. M. H. RASHID; M. F. HOQUE; M. S. B. JULI; M. KHATUN

160

Simvastatin treatment attenuates increased respiratory variability and apnea/hypopnea index in rats with chronic heart failure.  

PubMed

Cheyne-Stokes respiration and cardiac arrhythmias are associated with increased morbidity and mortality in patients with chronic heart failure (CHF). Enhanced carotid body chemoreflex (CBC) sensitivity is associated with these abnormalities in CHF. Reduced carotid body (CB) nitric oxide and nitric oxide synthase (NOS) levels play an important role in the enhanced CBC. In other disease models, Simvastatin (statin) treatment increases endothelial NOS, in part, by increasing Krüppel-like Factor 2 expression. We hypothesized that statin treatment would ameliorate enhanced CBC sensitivity as well as increased respiratory variability, apnea/hypopnea index, and arrhythmia index, in a rodent model of CHF. Resting breathing pattern, cardiac rhythm, and the ventilatory and CB chemoreceptor afferent responses to hypoxia were assessed in rats with CHF induced by coronary ligation. CHF was associated with enhanced ventilatory and CB afferent responses to hypoxia as well as increased respiratory variability, apnea/hypopnea index, and arrhythmia index. Statin treatment prevented the increases in CBC sensitivity and the concomitant increases in respiratory variability, apnea/hypopnea index, and arrhythmia index. Krüppel-like Factor 2 and endothelial NOS protein were decreased in the CB and nucleus tractus solitarii of CHF animals, and statin treatment increased the expression of these proteins. Our findings demonstrate that the increased CBC sensitivity, respiratory instability, and cardiac arrhythmias observed in CHF are ameliorated by statin treatment and suggest that statins may be an effective treatment for Cheyne-Stokes respiration and arrhythmias in patient populations with high chemoreflex sensitivity. PMID:24516105

Haack, Karla K V; Marcus, Noah J; Del Rio, Rodrigo; Zucker, Irving H; Schultz, Harold D

2014-05-01

161

Acute respiratory failure onset in a patient with Guillain-Barré syndrome after Legionella-associated pneumonia: a case report.  

PubMed

A 69-year-old white man was admitted because of a clinical history of persistent cough and fever. Chest x-rays showed bilateral lung infiltrates with air bronchograms, whereas the urine antigen test resulted positive for Legionella pneumophila. The next day, he was transferred to the intensive care unit and intubated because of severe renal and respiratory distress. Neurological examination revealed distal weakness and loss of deep tendon reflexes in lower extremities. Nerve conduction studies displayed severe demyelinating sensorimotor polyneuropathy, and plasmapheresis was therefore applied with mild improvement. Few weeks after, dysphagia occurred and electrophysiologic tests showed progressive axonal involvement with spread of demyelination to the cranial nerves. The patient underwent a new plasmapheresis course and slowly reached stable clinical improvement of neurological status, which allowed him to be safely discharged. This case showed a critical onset with respiratory failure and kidney functional impairment due to L. pneumophila, subsequently disclosing Guillain-Barré syndrome. PMID:25415518

Vigneri, Simone; Spadaro, Savino; Farinelli, Ilaria; Ragazzi, Riccardo; Volta, Carlo A; Capone, Jay G; Sette, Elisabetta; Tugnoli, Valeria

2014-12-01

162

Common-Cause Failure Treatment in Event Assessment: Basis for a Proposed New Model  

SciTech Connect

Event assessment is an application of probabilistic risk assessment in which observed equipment failures and outages are mapped into the risk model to obtain a numerical estimate of the event’s risk significance. In this paper, we focus on retrospective assessments to estimate the risk significance of degraded conditions such as equipment failure accompanied by a deficiency in a process such as maintenance practices. In modeling such events, the basic events in the risk model that are associated with observed failures and other off-normal situations are typically configured to be failed, while those associated with observed successes and unchallenged components are assumed capable of failing, typically with their baseline probabilities. This is referred to as the failure memory approach to event assessment. The conditioning of common-cause failure probabilities for the common cause component group associated with the observed component failure is particularly important, as it is insufficient to simply leave these probabilities at their baseline values, and doing so may result in a significant underestimate of risk significance for the event. Past work in this area has focused on the mathematics of the adjustment. In this paper, we review the Basic Parameter Model for common-cause failure, which underlies most current risk modelling, discuss the limitations of this model with respect to event assessment, and introduce a proposed new framework for common-cause failure, which uses a Bayesian network to model underlying causes of failure, and which has the potential to overcome the limitations of the Basic Parameter Model with respect to event assessment.

Dana Kelly; Song-Hua Shen; Gary DeMoss; Kevin Coyne; Don Marksberry

2010-06-01

163

A model of the deciliation process caused by Mycoplasma fermentans strain incognitus on respiratory epithelium.  

PubMed

The aim of this study was to investigate by light microscopy as well as by scanning and transmission electron microscopy the deciliation process which takes place on the respiratory epithelium of tracheal explants after experimental infection with Mycoplasma fermentans strain incognitus. Time-point photography allowed distinguishing five phases which occurred during the infection on the epithelial cell surface: (1) Attachment of M. fermentans to the cilia causing clumping of the cilia tips; (2) matting of cilia into bundles; (3) formation of abnormally shaped and shorter cilia; (4) collapse of cilia onto the epithelial cell surface; and (5) widespread loss of cilia. Based on the photographic images, a schematic model of the deciliation process was developed. Various potential factors contributing to the cilia destruction are discussed, including the release of mycoplasmal toxins, the physical presence of a high number of M. fermentans cells attached to the cilia, and the depletion of culture medium components by the mycoplasmas. This model of M. fermentans strain incognitus infection of respiratory epithelium is important for understanding mycoplasmal pathogenicity on a comparative level. PMID:16898668

Stadtländer, Christian T K H

2006-01-01

164

Respiratory epithelial cytotoxicity and membrane damage (holes) caused by amine-modified nanoparticles.  

PubMed

The respiratory epithelium is a significant target of inhaled, nano-sized particles, the biological reactivity of which will depend on its physicochemical properties. Surface-modified, 50 and 100 nm, polystyrene latex nanoparticles (NPs) were used as model particles to examine the effect of particle size and surface chemistry on transformed human alveolar epithelial type 1-like cells (TT1). Live images of TT1 exposed to amine-modified NPs taken by hopping probe ion conductance microscopy revealed severe damage and holes on cell membranes that were not observed with other types of NPs. This paralleled induction of cell detachment, cytotoxicity and apoptotic (caspase-3/7 and caspase-9) cell death, and increased release of CXCL8 (IL-8). In contrast, unmodified, carboxyl-modified 50 nm NPs and the 100 nm NPs did not cause membrane damage, and were less reactive. Thus, the susceptibility and membrane damage to respiratory epithelium following inhalation of NPs will depend on both surface chemistry (e.g., cationic) and nano-size. PMID:21352086

Ruenraroengsak, Pakatip; Novak, Pavel; Berhanu, Deborah; Thorley, Andrew J; Valsami-Jones, Eugenia; Gorelik, Julia; Korchev, Yuri E; Tetley, Teresa D

2012-02-01

165

Hypercapnic respiratory failure and partial upper airway obstruction during high frequency oscillatory ventilation in an adult burn patient  

Microsoft Academic Search

Purpose  To present a case of severe hypercapnic respiratory failure in an adult burn patient and to describe our clinical problem\\u000a solving approach during support with an unconventional mode of mechanical ventilation.\\u000a \\u000a \\u000a \\u000a Clinical features  A 19-yr-old male with smoke inhalation and flame burns to 50% total body surface area was admitted to the Ross Tilley Burn\\u000a Centre. High frequency oscillatory ventilation (HFOV)

Andrew B. Cooper; Avinash Islur; Manuel Gomez; Gordon L. Goldenson; Robert C. Cartotto

2002-01-01

166

Reversible congestive heart failure caused by myocardial hibernation.  

PubMed Central

Myocardial hibernation is reversible contractile dysfunction of cardiac myocytes caused by chronic ischemia. Animal studies and observations in human beings suggest that the term hibernation is a misnomer. Repetitive ischemic insult that does not produce necrosis results in functional and histologic tissue deterioration, which culminates in myocyte apoptosis. Revascularization of "hibernating" myocardium results in partial or complete recovery of function, depending upon the duration of ischemia and the severity of cellular degeneration. Improvement in global left ventricular function is proportional to the quantity of hibernating tissue that is revascularized, but this threshold quantity has not been determined with certainty. Diagnostic methods used to detect viable tissue within akinetic left ventricular segments depend upon the recognition of recruitable contractile function or the active concentration of a radioactive tracer. No diagnostic method has shown clear superiority. The most sensitive methods appear to be single-photon emission computed tomographic imaging after reinjection of thallium-201 at 24 hours and positron-emission tomographic imaging with 18F-fluorodeoxyglucose. The most specific diagnostic method appears to be measurement of dobutamine-stimulated contractile function, using either echocardiography or gated magnetic resonance imaging. We present a review of the pathophysiology, diagnosis, and treatment of myocardial hibernation, and include an illustrative case report involving a 57-year-old man with myocardial hibernation. Images PMID:10217467

Wilson, J M

1999-01-01

167

Scrub Typhus Complicated by Acute Respiratory Distress Syndrome and Multiorgan Failure; an Unrecognized Alarming Entity in Central India: A Report of Two Cases  

PubMed Central

Scrub typhus is an acute infectious illness, distributed throughout the Asia Pacific rim. In India, it has been reported from northern, eastern, and southern India. However, cases of scrub typhus have not been well-documented from Vidarbha, an eastern region of Maharashtra state in central India. We report two cases of complicated scrub typhus from Vidarbha region. These cases admitted in unconscious state with 8-10 days history of fever, body ache, cough, and progressive breathlessness. The diagnosis in both cases was based on presence of eschar, a positive Weil-Felix test, and a positive rapid diagnostic test (immunochromatographic assay). Both cases were complicated by acute respiratory distress syndrome (ARDS) and multiorgan failure. Both of them presented in their 2nd week of illness and died during the hospital course in spite of intensive supportive care. The main cause of mortality was delayed referral leading to delay in diagnosis and treatment. PMID:24791245

Saxena, Amrish; Khiangte, Benjamine; Tiewsoh, Iadarilang

2014-01-01

168

Ocular Tropism of Respiratory Viruses  

PubMed Central

SUMMARY Respiratory viruses (including adenovirus, influenza virus, respiratory syncytial virus, coronavirus, and rhinovirus) cause a broad spectrum of disease in humans, ranging from mild influenza-like symptoms to acute respiratory failure. While species D adenoviruses and subtype H7 influenza viruses are known to possess an ocular tropism, documented human ocular disease has been reported following infection with all principal respiratory viruses. In this review, we describe the anatomical proximity and cellular receptor distribution between ocular and respiratory tissues. All major respiratory viruses and their association with human ocular disease are discussed. Research utilizing in vitro and in vivo models to study the ability of respiratory viruses to use the eye as a portal of entry as well as a primary site of virus replication is highlighted. Identification of shared receptor-binding preferences, host responses, and laboratory modeling protocols among these viruses provides a needed bridge between clinical and laboratory studies of virus tropism. PMID:23471620

Rota, Paul A.; Tumpey, Terrence M.

2013-01-01

169

Natural Killer Cells Are Involved in Acute Lung Immune Injury Caused by Respiratory Syncytial Virus Infection  

PubMed Central

It is known that respiratory syncytial virus (RSV) is the main cause of bronchiolitis and pneumonia in young children. RSV infection often leads to severe acute lung immunopathology, but the underlying immune mechanisms are not yet fully elucidated. Here, we found that RSV infection induced severe acute lung immune injury and promoted the accumulation and activation of lung natural killer (NK) cells at the early stage of infection in BALB/c mice. Activated lung NK cells highly expressed activating receptors NKG2D and CD27 and became functional NK cells by producing a large amount of gamma interferon (IFN-?), which was responsible for acute lung immune injury. NK cell depletion significantly attenuated lung immune injury and reduced infiltration of total inflammatory cells and production of IFN-? in bronchoalveolar lavage fluid (BALF). These data show that NK cells are involved in exacerbating the lung immune injury at the early stage of RSV infection via IFN-? secretion. PMID:22171263

Li, Fengqi; Zhu, Hanqing; Sun, Rui; Wei, Haiming

2012-01-01

170

Evaluation of OPC-17116 against important pathogens that cause respiratory tract infections.  

PubMed Central

The antibacterial activity of OPC-17116, a new fluoroquinolone antibacterial agent, against important pathogens that cause respiratory tract infections was evaluated in vitro and in vivo and compared with those of ciprofloxacin, ofloxacin, and norfloxacin. The pharmacokinetic profiles of OPC-17116 were studied in both mice and rats given the drug orally at doses of 50 and 40 mg/kg of body weight, respectively. OPC-17116 showed a high degree of distribution in the lung tissues of both species, with maximum concentrations of 29.6 and 32.0 micrograms/g, respectively. Furthermore, the drug concentrations in lung tissue were about 10 to 15 times greater than the concentrations in plasma. OPC-17116 showed potent antibacterial activity against such pathogens as Staphylococcus aureus, Streptococcus pneumoniae, Klebsiella pneumoniae, Pseudomonas aeruginosa, Haemophilus influenzae, and Moraxella catarrhalis. The MICs of this compound for 90% of these organisms except methicillin-resistant S. aureus and P. aeruginosa ranged from < or = 0.006 to 0.78 microgram/ml. The in vitro antibacterial activity of OPC-17116 was reflected by the efficacy of a single oral dose against systemic bacterial infections in mice. OPC-17116 showed a superior effect against gram-positive bacteria, H. influenzae, and M. catarrhalis. In comparison with the other reference compounds, the efficacy of OPC-17116 was less than that of ciprofloxacin against K. pneumoniae and P. aeruginosa. OPC-17116 showed a greater therapeutic effect than the other drugs against experimental acute pneumonia caused by these organisms in mice or rats. This excellent therapeutic effect against respiratory tract infections may be a result of its high level of distribution in lung tissue. PMID:7840567

Wakebe, H; Imada, T; Yoneda, H; Mukai, F; Ohguro, K; Ohmori, K; Tamaoka, H; Yabuuchi, Y

1994-01-01

171

Low-frequency positive-pressure ventilation with extracorporeal CO2 removal in severe acute respiratory failure.  

PubMed

Forty-three patients were entered in an uncontrolled study designed to evaluate extracorporeal membrane lung support in severe acute respiratory failure of parenchymal origin. Most of the metabolic carbon dioxide production was cleared through a low-flow venovenous bypass. To avoid lung injury from conventional mechanical ventilation, the lungs were kept "at rest" (three to five breaths per minute) at a low peak airway pressure of 35 to 45 cm H2O (3.4 to 4.4 kPa). The entry criteria were based on gas exchange under standard ventilatory conditions (expected mortality rate, greater than 90%). Lung function improved in thirty-one patients (72.8%), and 21 patients (48.8%) eventually survived. The mean time on bypass for the survivors was 5.4 +/- 3.5 days. Improvement in lung function, when present, always occurred within 48 hours. Blood loss averaged 1800 +/- 850 mL/d. No major technical accidents occurred in more than 8000 hours of perfusion. Extracorporeal carbon dioxide removal with low-frequency ventilation proved a safe technique, and we suggest it as a valuable tool and an alternative to treating severe acute respiratory failure by conventional means. PMID:3090285

Gattinoni, L; Pesenti, A; Mascheroni, D; Marcolin, R; Fumagalli, R; Rossi, F; Iapichino, G; Romagnoli, G; Uziel, L; Agostoni, A

1986-08-15

172

Revision Hip Arthroplasty: Infection is the Most Common Cause of Failure  

Microsoft Academic Search

Background  Revision total hip arthroplasty (THA), although relieving pain and restoring function, fails in some patients. In contrast\\u000a to failures in primary THA, the frequency of the causes of failure in revision THA has been less well established.\\u000a \\u000a \\u000a \\u000a \\u000a Questions\\/purposes  We therefore determined the rate of each failure mode and the survivorship of revision THAs.\\u000a \\u000a \\u000a \\u000a Methods  We retrospectively reviewed the charts of 1366 revision

S. Mehdi Jafari; Catelyn Coyle; S. M. Javad Mortazavi; Peter F. Sharkey; Javad Parvizi

2010-01-01

173

Oscillatory behavior of ventricular action potential duration in heart failure patients at respiratory rate and low frequency  

PubMed Central

Oscillations of arterial pressure occur spontaneously at a frequency of approximately 0.1 Hz coupled with synchronous oscillations of sympathetic nerve activity (“Mayer waves”). This study investigated the extent to which corresponding oscillations may occur in ventricular action potential duration (APD). Fourteen ambulatory (outpatient) heart failure patients with biventricular pacing devices were studied while seated upright watching movie clips to maintain arousal. Activation recovery intervals (ARI) as a measure of ventricular APD were obtained from unipolar electrograms recorded from the LV epicardial pacing lead during steady state RV pacing from the device. Arterial blood pressure was measured non-invasively (Finapress) and respiration monitored. Oscillations were quantified using time frequency and coherence analysis. Oscillatory behavior of ARI at the respiratory frequency was observed in all subjects. The magnitude of the ARI variation ranged from 2.2 to 6.9 ms (mean 5.0 ms). Coherence analysis showed a correlation with respiratory oscillation for an average of 43% of the recording time at a significance level of p < 0.05. Oscillations in systolic blood pressure in the Mayer wave frequency range were observed in all subjects for whom blood pressure was recorded (n = 13). ARI oscillation in the Mayer wave frequency range was observed in 6/13 subjects (46%) over a range of 2.9 to 9.2 ms. Coherence with Mayer waves at the p < 0.05 significance level was present for an average of 29% of the recording time. In ambulatory patients with heart failure during enhanced mental arousal, left ventricular epicardial APD (ARI) oscillated at the respiratory frequency (approximately 0.25 Hz). In 6 patients (46%) APD oscillated at the slower Mayer wave frequency (approximately 0.1 Hz). These findings may be important in understanding sympathetic activity-related arrhythmogenesis. PMID:25389408

Hanson, Ben; Child, Nick; Van Duijvenboden, Stefan; Orini, Michele; Chen, Zhong; Coronel, Ruben; Rinaldi, Christopher A.; Gill, Jaspal S.; Gill, Jaswinder S.; Taggart, Peter

2014-01-01

174

Observational Failures\\/Distraction and Disease Attack\\/Incapacity as Cause(s) of Fatal Road Crashes in Finland  

Microsoft Academic Search

Objective: To study the incidence of health-related conditions and observational failures\\/distraction (OFD) as an immediate cause for fatal motor vehicle accidents (FMVA) and to correlate them with driver's age.Methods: Retrospective study of all FMVA in Finland secondary to OFD from January 1995 to December 2005 and FMVA secondary to a disease attack\\/incapacity (DA) from January 2003 to December 2004.The data

Timo M. T. Tervo; Waldir Neira; Aarne Kivioja; Pekka Sulander; Kalle Parkkari; Juha M. Holopainen

2008-01-01

175

Respiratory Failure Due to Differentiation Arrest and Expansion of Alveolar Cells following Lung-Specific Loss of the Transcription Factor C\\/EBP  in Mice  

Microsoft Academic Search

The leucine zipper family transcription factor CCAAT enhancer binding protein alpha (C\\/EBP) inhibits proliferation and promotes differentiation in various cell types. In this study, we show, using a lung-specific conditional mouse model of C\\/EBP deletion, that loss of C\\/EBP in the respiratory epithelium leads to respiratory failure at birth due to an arrest in the type II alveolar cell differentiation

Daniela S. Basseres; Elena Levantini; Hongbin Ji; Stefano Monti; Shannon Elf; Tajhal Dayaram; Maris Fenyus; Olivier Kocher; Todd Golub; Kwok-kin Wong; Balazs Halmos; Daniel G. Tenen

2006-01-01

176

Miliary tuberculosis and adult respiratory distress syndrome  

Microsoft Academic Search

Although, miliary tuberculosis is an unusual cause of severe acute respiratory failure, we describe nine patients with miliary tuberculosis who developed adult respiratory distress syndrome. This complication occurred in seven patients despite treatment with antituberculous drugs. In two patients who developed the syndrome, miliary tuberculosis was diagnosed only at postmortem. The presence of pulmonary hypertension in all cases and disseminated

A. Roglan Piqueras; L. Marruecos; A. Artigas; C. Rodriguez

1987-01-01

177

Acute Respiratory Failure and Active Bleeding Are the Important Fatality Predictive Factors for Severe Dengue Viral Infection  

PubMed Central

Objective To determine the outcome of severe dengue viral infection (DVI) and the main dengue fatality risk factors. Study design The medical records of patients aged <15 years admitted to Songklanagarind Hospital in southern Thailand during 1989–2011 were reviewed. Patients who had dengue hemorrhagic fever (DHF) grades III–IV, organ failure (cardiovascular, respiratory, liver, renal or hematologic), impaired consciousness, or aspartate aminotransferase more than 1,000 units/L, were classified as having severe DVI. To determine the fatality risk factors of severe DVI, the classification trees were constructed based on manual recursive partitioning. Results Of the 238 children with severe DVI, 30 (12.6%) died. Compared to the non-fatal DVI cases, the fatal cases had higher rates of DHF grade IV (96.7% vs 24.5%), repeated shock (93.3% vs 27.9%), acute respiratory failure (ARF) (100% vs 6.7%), acute liver failure (ALF) (96.6% vs 6.3%), acute kidney injury (AKI) (79.3% vs 4.5%), and active bleeding requiring blood transfusion (93.3% vs 5.4%), all p<0.01. The combined risk factors of ARF and active bleeding considered together predicted fatal outcome with sensitivity, specificity, and negative and positive predictive values of 0.93 (0.78–0.99), 0.97 (0.93–0.99), 0.99 (0.97–1.00), and 0.82 (0.65–0.93), respectively. The likelihood ratios for a fatal outcome in the patients who had and did not have this risk combination were 32.4 (14.6–71.7) and 0.07 (0.02–0.26), respectively. Conclusion Severe DVI patients who have ARF and active bleeding are at a high risk of death, while patients without these things together should survive. PMID:25460594

Laoprasopwattana, Kamolwish; Chaimongkol, Wanwipa; Pruekprasert, Pornpimol; Geater, Alan

2014-01-01

178

Acute Respiratory Distress Syndrome Caused by Pulmonary and Extrapulmonary Disease Different Syndromes?  

Microsoft Academic Search

To assess the possible differences in respiratory mechanics between the acute respiratory distress syndrome (ARDS) originating from pulmonary disease (ARDS p ) and that originating from extrapul- monary disease (ARDS exp ) we measured the total respiratory system (Est,rs), chest wall (Est,w) and lung (Est,L) elastance, the intra-abdominal pressure (IAP), and the end-expiratory lung volume (EELV) at 0, 5, 10,

LUCIANO GATTINONI; PAOLO PELOSI; PETER M. SUTER; ALESSIA PEDOTO; PAOLA VERCESI; ALFREDO LISSONI

179

A method for estimating common cause failure probability and model parameters : the inverse stress-strength interference (ISSI) technique  

E-print Network

In this study, an alternative for the analysis of common cause failures (CCFs) is investigated. The method studied consists of using the Licensee Event Report (LER) data to get single component failure probability and using ...

Guey, Ching Ning

1984-01-01

180

Acute respiratory failure following pharmacologically induced hyperventilation: an experimental animal study.  

PubMed

The pulmonary effects of hyperventilation following infusion of sodium salicylate into the cisterna magna was studied in 16 spontaneously breathing adult sheep. We found a fall in PaO2, a decrease in the static compliance of the respiratory system, abnormal chest roentgenographic films, and grossly abnormal lungs following 3.5 to 13 h of hyperventilation. A control group of 15 sheep (10 sheep similarly injected with sodium salicylate, but then sedated and paralyzed and ventilated at normal tidal volume and respiratory rate on a mechanical ventilator, and 5 sheep infused with saline alone and breathing spontaneously) showed no pulmonary or arterial blood gas abnormalities. We conclude that prolonged hyperventilation under the conditions of this experiment precipitated events that resulted in acute lung injury. PMID:3230208

Mascheroni, D; Kolobow, T; Fumagalli, R; Moretti, M P; Chen, V; Buckhold, D

1988-01-01

181

What is Measles? Measles, also known as Rubeola, is a highly contagious respiratory infection caused by a virus.  

E-print Network

respiratory infection caused by a virus. Measles can lead to permanent disability and even death of infants infected with the measles virus, symptoms typically begin 7 to 14 days later. Some common early symptoms birth, or a low-birth-weight baby. How do I treat it? Measles is a virus, so it needs to run its course

182

Acute respiratory failure following pharmacologically induced hyperventilation: an experimental animal study  

Microsoft Academic Search

The pulmonary effects of hyperventilation following infusion of sodium salicylate into the cisterna magna was studied in 16 spontaneously breathing adult sheep. We found a fall in PaO2, a decrease in the static compliance of the respiratory system, abnormal chest roentgenographic films, and grossly abnormal lungs following 3.5 to 13 h of hyperventilation. A control group of 15 sheep (10

D. Mascheroni; T. Kolobow; R. Fumagalli; M. P. Moretti; V. Chen; D. Buck-hold

1988-01-01

183

Dome shutter failure causes longest shutdown (67-nights) ever recorded by CFHT Observatory  

NASA Astrophysics Data System (ADS)

The dome shutter drive system for the CFHT observatory experienced two, separate, catastrophic failures recently (15 DEC 11) and (14 APR 12); leading to a full-blown, company-wide investigation to understand and determine the root cause of both failures. Multiple resources were utilized to detect and reveal clues to help determine the cause of failure. Former colleagues were consulted, video footage investigated, ammeter plots dissected, solid models developed, forensic analysis of failed parts performed, controller mock-up established; all in an attempt to gather data, better understand the system, and develop a clear path solution to resurrect the shutter and return it to normal operation. My paper will attempt to describe in detail the problems encountered, investigations performed, analysis developed, and solutions integrated.

Look, Ivan A.; Salmon, Derrick; Bauman, Steve; Ho, Kevin; Elizares, Casey

2014-07-01

184

Investigating the causes of reading comprehension failure: The comprehension-age match design  

Microsoft Academic Search

The reading-level (or reading-age) match design has become a widely-used tool for investigating the possible direction of the relation between particular skills and word reading ability: Cause or consequence. This paper outlines an analogous method for identifying can- didate causes of reading comprehension failure, the 'comprehension-age match design' and discusses the strengths and limitations of this design.

KATE CAIN; JANE OAKHILL; PETER BRYANT

2000-01-01

185

Causes of failure of heat-resistant steel piping in Parex-1 units  

Microsoft Academic Search

One of the causes of equipment failures in petroleum refineries is the nitriding of steels in ammonia media at high temperatures and pressures. At 350-600~ ammonia dissociates into hydrogen and nitrogen. The nitrogen, diffusing into the metal, forms brittle nitride layers that are susceptible to cracking in the course of long-term service. The process of saturation with nitrogen depends on

V. V. Burlov; T. P. Parputs; O. A. Demeshko

1993-01-01

186

Respiratory allergy caused by house dust mites: What do we really know?  

PubMed

The house dust mite (HDM) is a major perennial allergen source and a significant cause of allergic rhinitis and allergic asthma. However, awareness of the condition remains generally low. This review assesses the links between exposure to HDM, development of the allergic response, and pathologic consequences in patients with respiratory allergic diseases. We investigate the epidemiology of HDM allergy to explore the interaction between mites and human subjects at the population, individual, and molecular levels. Core and recent publications were identified by using "house dust mite" as a key search term to evaluate the current knowledge of HDM epidemiology and pathophysiology. Prevalence data for HDM allergen sensitization vary from 65 to 130 million persons in the general population worldwide to as many as 50% among asthmatic patients. Heterogeneity of populations, terminology, and end points in the literature confound estimates, indicating the need for greater standardization in epidemiologic research. Exposure to allergens depends on multiple ecological strata, including climate and mite microhabitats within the domestic environment, with the latter providing opportunity for intervention measures to reduce allergen load. Inhaled mite aeroallergens are unusually virulent: they are able to activate both the adaptive and innate immune responses, potentially offering new avenues for intervention. The role of HDM allergens is crucial in the development of allergic rhinitis and asthma, but the translation of silent sensitization into symptomatic disease is still incompletely understood. Improved understanding of HDMs, their allergens, and their microhabitats will enable development of more effective outcomes for patients with HDM allergy. PMID:25457152

Calderón, Moisés A; Linneberg, Allan; Kleine-Tebbe, Jörg; De Blay, Frédéric; Hernandez Fernandez de Rojas, Dolores; Virchow, Johann Christian; Demoly, Pascal

2014-11-22

187

Type I Arnold-Chiari malformation with bronchiectasis, respiratory failure, and sleep disordered breathing: a case report  

PubMed Central

Arnold Chiari Malformation (ACM) is defined as a condition where part of the cerebellar tissue herniates into the cervical canal toward the medulla and spinal cord resulting in a number of clinical manifestations. Type I ACM consists of variable displacement of the medulla throughout the formamen magnum into the cervical canal, with prominent cerebellar herniation. Type I ACM is characterized by symptoms related to the compression of craniovertebral junction, including ataxia, dysphagia, nistagmus, headache, dizziness, and sleep disordered breathing. We report a case of a life-long non-smoker, 54 years old woman who presented these symptoms associated with bronchiectasis secondary to recurrent inhalation pneumonia, hypercapnic respiratory failure, and central sleep apnea (CSA). CSA was first unsuccessfully treated with nocturnal c-PAP. The subsequent treatment with low flow oxygen led to breathing pattern stabilization with resolution of CSA and related clinical symptoms during sleep. We suggest that in patients with type I ACM the presence of pulmonary manifestations aggravating other respiratory disturbances including sleep disordered breathing (SDB) should be actively investigated. The early diagnosis is desirable in order to avoid serious and/or poorly reversible damages. PMID:23433005

2013-01-01

188

Association between Sjogren's Syndrome and Respiratory Failure: Put Airway, Interstitia, and Vessels Close Together: A National Cohort Study  

PubMed Central

Objectives Few studies have evaluated the association between Sjogren's syndrome (SS) and respiratory failure (RF). Thus, we conducted a retrospective national cohort study to investigate whether Sjogren's syndrome (SS) increases the risk of respiratory failure (RF). Methods The cohort consisted of 4954 newly diagnosed patients with SS but without a previous diagnosis of RF, and 19816 patients as the comparison cohort from the catastrophic illnesses registry, obtained from the 2000–2005 period. All of the study participants were followed from the index date to December 31, 2011. We analyzed the association between the risk of RF and SS by using a Cox proportional hazards regression model, controlling for sex, age, and comorbidities. Results The overall incidence rate of RF showed a 3.21-fold increase in the SS cohort compared with the comparison cohort. The adjusted HR of RF was 3.04 for the SS cohort compared with the comparison cohort, after we adjusted for sex, age, and comorbidities. The HRs of RF for patients with primary SS and secondary SS compared with the comparison cohort were 2.99 and 3.93, respectively (P for trend <.001). The HRs of RF increased as the severity of SS increased, from 2.34 for those with no inpatient care experience to 5.15 for those with inpatient care experience (P for trend <.001). Conclusion This study indicates that clinical physicians should not only consider secondary SS but also primary SS as a critical factor that increases the risk of RF. PMID:25350278

Yeh, Jun-Jun; Chen, Hsuan-Ju; Li, Tsai-Chung; Wong, Yi-Sin; Tang, Hsien-Chin; Yeh, Ting-Chun; Kao, Chia-Hung

2014-01-01

189

Non-invasive positive pressure ventilation to treat respiratory failure resulting from exacerbations of chronic obstructive pulmonary disease: Cochrane systematic review and meta-analysis  

PubMed Central

Objectives To determine the effectiveness of non-invasive positive pressure ventilation (NPPV) in the management of respiratory failure secondary to acute exacerbation of chronic obstructive pulmonary disease. Design Systematic review of randomised controlled trials that compared NPPV and usual medical care with usual medical care alone in patients admitted to hospital with respiratory failure resulting from an exacerbation of chronic obstructive pulmonary disease and with PaCO2 >6 kPa. Results The eight studies included in the review showed that, compared with usual care alone, NPPV as an adjunct to usual care was associated with a lower mortality (relative risk 0.41 (95% confidence interval 0.26 to 0.64)), a lower need for intubation (relative risk 0.42 (0.31 to 0.59)), lower likelihood of treatment failure (relative risk 0.51 (0.38 to 0.67)), and greater improvements at 1 hour in pH (weighted mean difference 0.03 (0.02 to 0.04)), PaCO2 (weighted mean difference ?0.40 kPa (?0.78 to ?0.03)), and respiratory rate (weighted mean difference ?3.08 breaths per minute (?4.26 to ?1.89)). NPPV resulted in fewer complications associated with treatment (relative risk 0.32 (0.18 to 0.56)) and shorter duration of stay in hospital (weighted mean difference ?3.24 days (?4.42 to ?2.06)). Conclusions NPPV should be the first line intervention in addition to usual medical care to manage respiratory failure secondary to an acute exacerbation of chronic obstructive pulmonary disease in all suitable patients. NPPV should be tried early in the course of respiratory failure and before severe acidosis, to reduce mortality, avoid endotracheal intubation, and decrease treatment failure. What is already known on this topicProspective studies, especially the larger studies, have shown that non-invasive positive pressure ventilation (NPPV) reduces the need for intubation, improves survival, and reduces complications in patients with respiratory failure resulting from exacerbation of chronic obstructive pulmonary disease (COPD)A previous meta-analysis showed NPPV to be an effective intervention, including for acute exacerbations of COPD, but some studies in this meta-analysis contained mixed groups of patients and were not of good qualityWhat this study addsEvidence from good quality, randomised controlled trials shows that NPPV is an effective treatment for acute exacerbations of COPDNPPV should be considered early in the course of respiratory failure and before severe acidosis ensues, to avoid the need for endotracheal intubation and reduce mortality in patients with COPD PMID:12543832

Lightowler, Josephine V; Wedzicha, Jadwiga A; Elliott, Mark W; Ram, Felix S F

2003-01-01

190

A Case of Fetal Parvovirus B19 Myocarditis That Caused Terminal Heart Failure  

PubMed Central

Parvovirus B19 is a well-established cause of fetal anemia and nonimmune fetal hydrops in pregnancy. Fetal parvovirus infection can cause severe destruction of erythroid progenitor cells, resulting in fetal anemia, hydrops, and intrauterine death. However, viral myocarditis with subsequent heart failure is another possible mechanism for hydrops formation as viral infection of fetal myocardial cells has been reported in postmortem examinations. We herein report a case of fetal cardiomegaly and massive pericardial effusion secondary to myocarditis as a result of parvovirus B19 infection. The case developed hydrops as consequence of severe anemia and experienced terminal heart failure, which led to the fetus dying an intrauterine death at 22 weeks of gestation. This case demonstrates that there may be an association between myocarditis caused by intrauterine parvovirus B19 infection and a poor outcome. The presence of viral myocarditis may be the determining prognostic factor in that situation. PMID:25328731

2014-01-01

191

Lifesaving liver transplantation for multi-organ failure caused by Bacillus cereus food poisoning.  

PubMed

Bacillus cereus is a spore-forming, gram-positive bacterium that causes food poisoning presenting with either emesis or diarrhea. Diarrhea is caused by proteinaceous enterotoxin complexes, mainly hemolysin BL, non-hemolytic enterotoxin (NHE), and cytotoxin K. In contrast, emesis is caused by the ingestion of the depsipeptide toxin cereulide, which is produced in B. cereus contaminated food, particularly in pasta or rice. In general, the illness is mild and self-limiting. However, due to cereulide intoxication, nine severe cases with rhabdomyolysis and/or liver failure, five of them lethal, are reported in literature. Here we report the first case of life-threatening liver failure and severe rhabdomyolysis in this context that could not be survived without emergency hepatectomy and consecutive liver transplantation. PMID:25323120

Tschiedel, Eva; Rath, Peter-Michael; Steinmann, Jörg; Becker, Heinz; Dietrich, Rudolf; Paul, Andreas; Felderhoff-Müser, Ursula; Dohna-Schwake, Christian

2015-02-01

192

Failure of a mine waste dump in Zimbabwe: Causes and consequences  

NASA Astrophysics Data System (ADS)

A combination of factors are considered important in causing the failure and subsequent development of a flowslide of a gold mine waste dump (or tailings dam) at Arcturus, near Harare, Zimbabwe. These factors comprise poor basal drainage, steep perimeter walls, saturation of the walls and basal sediments through continued spigoting of slurry during a period of heavy rainfall, and the effect of this saturation on the tailings. Properties of the tailings, eyewitness accounts, documentary evidence, and site characteristics are discussed. The failure and subsequent development of a fatal 300-m flowslide are reconstructed in a five-phase developmental model. The general applicability of the results is discussed.

Shakesby, Richard A.; Whitlow, J. Richard

1991-09-01

193

Bilateral stones as a cause of acute renal failure in the emergency department  

PubMed Central

BACKGROUND: Acute renal failure (ARF) due to obstructive uropathy is a urological emergency. The standard radiological investigations in the emergency setting include X-ray, ultrasonography and computed tomography. But occasionally the cause of obstruction may be elusive. METHODS: We present a case of obstructive uropathy due to bilateral stones presenting as acute renal failure. The patient underwent successful shock wave lithotripsy (SWL) for dissolution of calculi. RESULTS: The patient was successfully treated, and reported asymptomatic in a follow-up. CONCLUSION: Close collaboration between nephrological, urological, and radiological services is required. PMID:25215151

Alonso, Joaquín V.; cachinero, Pedro L.; Ubeda, Fran R.; Ruiz, Daniel J. L.; Blanco, Alfredo

2014-01-01

194

A robust Bayesian approach to modeling epistemic uncertainty in common-cause failure models  

SciTech Connect

In a standard Bayesian approach to the alpha-factor model for common-cause failure, a precise Dirichlet prior distribution models epistemic uncertainty in the alpha-factors. This Dirichlet prior is then updated with observed data to obtain a posterior distribution, which forms the basis for further inferences. In this paper, we adapt the imprecise Dirichlet model of Walley to represent epistemic uncertainty in the alpha-factors. In this approach, epistemic uncertainty is expressed more cautiously via lower and upper expectations for each alpha-factor, along with a learning parameter which determines how quickly the model learns from observed data. For this application, we focus on elicitation of the learning parameter, and find that values in the range of 1 to 10 seem reasonable. The approach is compared with Kelly and Atwood's minimally informative Dirichlet prior for the alpha-factor model, which incorporated precise mean values for the alpha-factors, but which was otherwise quite diffuse. Next, we explore the use of a set of Gamma priors to model epistemic uncertainty in the marginal failure rate, expressed via a lower and upper expectation for this rate, again along with a learning parameter. As zero counts are generally less of an issue here, we find that the choice of this learning parameter is less crucial. Finally, we demonstrate how both epistemic uncertainty models can be combined to arrive at lower and upper expectations for all common-cause failure rates. Thereby, we effectively provide a full sensitivity analysis of common-cause failure rates, properly reflecting epistemic uncertainty of the analyst on all levels of the common-cause failure model.

Matthias C. M. Troffaes; Gero Walter; Dana Kelly

2014-05-01

195

Reduced Ventilator Pressure and Improved P/F Ratio During Percutaneous Arteriovenous Carbon Dioxide Removal for Severe Respiratory Failure  

PubMed Central

Objective To evaluate the effect of percutaneous arteriovenous carbon dioxide removal (AVCO2R) on ventilator pressures and P/F ratio in a clinically relevant large-animal model of severe respiratory failure. Summary Background Data AVCO2R was developed as a simple arteriovenous shunt with a commercially available low-resistance gas exchange device of sufficient surface area for near-total CO2 removal. With an AV shunt 10% to 15% of cardiac output, AVCO2R allows a reduction in ventilator airway pressures without hypercapnia or the complex circuitry and monitoring required for conventional ECMO. Methods AVCO2R was applied to a new, clinically relevant large-animal model of severe respiratory failure created by smoke inhalation and cutaneous flame burn injury. Adult sheep (n = 9, 38 ± 6 kg) received a 40% total body surface area, third-degree cutaneous flame burn and 36 breaths of cotton smoke insufflation. After injury, all animals were placed on volume-controlled mechanical ventilation to achieve PaO2 > 60 mmHg and PaCO2 < 40 mmHg. Animals were placed on AVCO2R within 40 to 48 hours of injury when the PaO2/FiO2 was <200. Animals underwent cannulation of the carotid artery and jugular vein with percutaneous 10F arterial and 14F venous cannulas. Shunt flow was continuously monitored using an ultrasonic flow probe and calculated as a percentage of cardiac output. Results AVCO2R flows of 800 to 900 ml/min (11% to 13% cardiac output) achieved 77 to 104 ml/min of CO2 removal (95% to 97% total CO2 production) while maintaining normocapnia. Significant reductions in ventilator settings were tidal volume, 421.3 ± 39.8 to 270.0 ± 6.3 ml; peak inspiratory pressure, 24.8 ± 2.4 to 13.7 ± 0.7 cm H2O; minute ventilation, 12.7 ± 1.4 to 6.2 ± 0.8 L/min; respiratory rate, 25.4 ± 1.3 to 18.4 ± 1.8 breaths/min; and FiO2, 0.88 ± 0.1 to 0.39 ± 0.1. The P/F ratio increased from 151.5 ± 40.0 at baseline to 320.0 ± 17.8 after 72 hours. Conclusions Percutaneous AVCO2R allows near-total CO2 removal and significant reductions in ventilator pressures with improvement in the P/F ratio. PMID:10450736

Alpard, Scott K.; Zwischenberger, Joseph B.; Tao, Weike; Deyo, Donald J.; Bidani, Akhil

1999-01-01

196

Noninvasive Mechanical Ventilation in the Weaning of Patients with Respiratory Failure Due to Chronic Obstructive Pulmonary Disease A Randomized, Controlled Trial  

Microsoft Academic Search

Background: In patients with acute exacerbations of chronic obstructive pulmonary disease, mechanical venti­ lation is often needed. The rate of weaning failure is high in these patients, and prolonged mechanical ventilation increases intubation-associated complications. Objective: To determine whether noninvasive ventila­ tion improves the outcome of weaning from invasive me­ chanical ventilation. Design: Multicenter, randomized trial. Setting: Three respiratory intensive care

Stefano Nava; Nicolino Ambrosino; Enrico Clini; Maurizio Prato; Giacomo Orlando; Michele Vitacca; Paolo Brigada; Claudio Fracchia; Fiorenzo Rubini

197

Pulmonary fibrosis secondary to siderosis causing symptomatic respiratory disease: a case report  

E-print Network

impairment. Although not the first of its kind, we present an unusual case of pulmonary siderosis with symptomatic respiratory disease, most likely secondary to associated fibrosis. Case presentation A 66-year-old Caucasian man was referred to the outpatient...

McCormick, Liam M; Goddard, Martin; Mahadeva, Ravi

2008-08-05

198

Redistribution of heart failure as the cause of death: the Atherosclerosis Risk in Communities Study  

PubMed Central

Background Heart failure is sometimes incorrectly listed as the underlying cause of death (UCD) on death certificates, thus compromising the accuracy and comparability of mortality statistics. Statistical redistribution of the UCD has been used to examine the effect of misclassification of the UCD attributed to heart failure, but sex- and race-specific redistribution of deaths on coronary heart disease (CHD) mortality in the United States has not been examined. Methods We used coarsened exact matching to infer the UCD of vital records with heart failure as the UCD from 1999 to 2010 for decedents 55 years old and older from states encompassing regions under surveillance by the Atherosclerosis Risk in Communities (ARIC) Study (Maryland, Minnesota, Mississippi, and North Carolina). Records with heart failure as the UCD were matched on decedent characteristics (five-year age groups, sex, race, education, year of death, and state) to records with heart failure listed among the multiple causes of death. Each heart failure death was then redistributed to plausible UCDs proportional to the frequency among matched records. Results After redistribution the proportion of deaths increased for CHD, chronic obstructive pulmonary disease, diabetes, hypertensive heart disease, and cardiomyopathy, P?

2014-01-01

199

Sleep Disordered Breathing and Chronic Respiratory Failure in Patients with Chronic Pain on Long Term Opioid Therapy  

PubMed Central

Study Objectives: The use of opioid medication for chronic pain has been increasing. The main aim of this study was to assess how many patients on opioids for chronic pain had sleep disordered breathing (SDB) and the type of SDB. The impact of these medications on daytime arterial blood gas (ABG) measurements and psychomotor vigilance was also studied. Methods: Twenty-four patients (aged 18-75 years) on long-term opioids were prospectively recruited. Patients underwent home polysomnogram (PSG), psychomotor vigilance testing (PVT), and awake daytime ABG. Overnight PSG findings were compared to those of patients matched for age, sex, and BMI referred to our sleep service for evaluation of SDB. PVT results in the patient cohort were compared to PVT in healthy controls. Results: Forty-six percent of opioid patients had severe SDB as defined by an apnea hypopnea index (AHI) > 30/h. The severity of SDB was similar in opioid-treated pain clinic patients and sleep clinic patients (mean ± SD AHI: Opioid-treated patients 32.7 ± 25.6; Sleep Study comparator group 28.9 ± 24.6, p = 0.6). Opioid patients had a higher frequency of central apneas and a lower arousal index (CAI: 3.9 ± 8.3 vs. 0.3 ± 0.5 events/h; p = 0.004, AI 8.0 ± 4.1 vs. 20.1 ± 13.8, p < 0.001). Pain clinic patients had impaired gas exchange during sleep and wakefulness. Nine of 20 (45%) had daytime hypercapnia, indicating a surprising number were in chronic respiratory failure. Morphine equivalent doses correlated with the severity of SDB. PVT was impaired when compared to a healthy PVT comparator group (RT: Opioid-treated patients 0.43 ± 0.27: Healthy PVT comparator group 0.28 ± 0.03 sec; p < 0.001). Conclusions: Patients on long-term opioids frequently have severe SDB, which in part is central in origin. PVT was markedly impaired. Half of the patients studied have evidence of chronic ventilatory failure. Commentary: A commentary on this article appears in this issue on page 853. Citation: Rose AR, Catcheside PG, McEvoy RD, Paul D, Kapur D, Peak E, Vakulin A, Antic NA. Sleep disordered breathing and chronic respiratory failure in patients with chronic pain on long term opioid therapy. J Clin Sleep Med 2014;10(8):847-852. PMID:25126029

Rose, Anand R.; Catcheside, Peter G.; McEvoy, R. Doug; Paul, Denzil; Kapur, Dilip; Peak, Emily; Vakulin, Andrew; Antic, Nicholas A.

2014-01-01

200

NASA's Evolutionary Xenon Thruster (NEXT) Power Processing Unit (PPU) Capacitor Failure Root Cause Analysis  

NASA Technical Reports Server (NTRS)

The NASA's Evolutionary Xenon Thruster (NEXT) project is developing an advanced ion propulsion system for future NASA missions for solar system exploration. A critical element of the propulsion system is the Power Processing Unit (PPU) which supplies regulated power to the key components of the thruster. The PPU contains six different power supplies including the beam, discharge, discharge heater, neutralizer, neutralizer heater, and accelerator supplies. The beam supply is the largest and processes up to 93+% of the power. The NEXT PPU had been operated for approximately 200+ hours and has experienced a series of three capacitor failures in the beam supply. The capacitors are in the same, nominally non-critical location the input filter capacitor to a full wave switching inverter. The three failures occurred after about 20, 30, and 135 hours of operation. This paper provides background on the NEXT PPU and the capacitor failures. It discusses the failure investigation approach, the beam supply power switching topology and its operating modes, capacitor characteristics and circuit testing. Finally, it identifies root cause of the failures to be the unusual confluence of circuit switching frequency, the physical layout of the power circuits, and the characteristics of the capacitor.

Soeder, James F.; Pinero, Luis; Schneidegger, Robert; Dunning, John; Birchenough, Art

2012-01-01

201

NASA's Evolutionary Xenon Thruster (NEXT) Power Processing Unit (PPU) Capacitor Failure Root Cause Analysis  

NASA Technical Reports Server (NTRS)

The NASA s Evolutionary Xenon Thruster (NEXT) project is developing an advanced ion propulsion system for future NASA missions for solar system exploration. A critical element of the propulsion system is the Power Processing Unit (PPU) which supplies regulated power to the key components of the thruster. The PPU contains six different power supplies including the beam, discharge, discharge heater, neutralizer, neutralizer heater, and accelerator supplies. The beam supply is the largest and processes up to 93+% of the power. The NEXT PPU had been operated for approximately 200+ hr and has experienced a series of three capacitor failures in the beam supply. The capacitors are in the same, nominally non-critical location-the input filter capacitor to a full wave switching inverter. The three failures occurred after about 20, 30, and 135 hr of operation. This paper provides background on the NEXT PPU and the capacitor failures. It discusses the failure investigation approach, the beam supply power switching topology and its operating modes, capacitor characteristics and circuit testing. Finally, it identifies root cause of the failures to be the unusual confluence of circuit switching frequency, the physical layout of the power circuits, and the characteristics of the capacitor.

Soeder, James F.; Scheidegger, Robert J.; Pinero, Luis R.; Birchenough, Arthur J.; Dunning, John W.

2012-01-01

202

Premature Ovarian Failure: A Critical Condition in The Reproductive Potential with Various Genetic Causes  

PubMed Central

Premature ovarian failure (POF) is identified as a heterogeneous disorder leading to amenorrhea and ovarian failure before the age of 40 years. The first known symptom of the disease is having irregular menstrual periods. The phenotype appearance of POF depends significantly on the variations in hormones. Low levels of gonadal hormones (estrogens and inhibins) and increased level of gonadotropins [luteinizing hormone (LH) and Follicle stimulating hormone (FSH)] (hypergonadotropic amenorrhea) are well documented as causes of POF. There is an association between the failure of germ cell development and complete ovarian failure, and consistently decreased number of germ cells is more likely associated with partial ovarian failure resulting in secondary amenorrhea. A literature review on recent findings about POF and its association with genomic alterations in terms of genes and chromosomes. POF is a complex heterogeneous disorder. Some of POF cases are carriers of a single gene mutation inherited in an autosomal or X-linked manner while a number of patients suffer from a chromosome abnormality like Turner syndrome in mosaic form and manifest secondary amenorrhea associated with ovarian dysgenesis. Among many of the known involved genes in POF development, several are prove to be positively associated to the disease development in different populations. While there is a promising association between X chromosome anomalies and specific gene mutations with POF, genome-wide analysis could prove a powerful tool for identifying the most important candidate genes that influence POF manifestation. PMID:24696764

Pouresmaeili, Farkhondeh; Fazeli, Zahra

2014-01-01

203

Causes of two slope-failure types in continental-shelf sediment, northeastern Gulf of Alaska  

USGS Publications Warehouse

Slumps and sediment-gravity flows have been identified in Holocene glaciomarine sediment on declivities less than 1.3 degrees on the Gulf of Alaska continental shelf. Geologic and geotechnical investigation suggest that the processes responsible for these slope failures are earthquake and storm-wave loading, coupled with cyclic degradation of the sediment-shear strength. We propose that the failure type is related to the nature of the failure load. For example, a slump that occurs approximately 30 km seaward of Icy Bay in water depth of 70 to 150 m was most likely caused by earthquake loading, whereas sediment-gravity flows on the Alsek prodelta, which occur in water depths of 35 to 80 m, probably were caused primarily by storm-wave loading. Sediment remolding and redistribution and incorporation of water, which occurs more readily during wave loading from a long storm than during the limited number of loading cycles generated by an earthquake, reduces the shear strength and increases the fluidity of the failed sediment mass. Wave-induced slope failures thereby tend to transform into sediment-gravity flows.

Schwab, William C.; Lee, Homa J.

1988-01-01

204

Questioning the Role of Requirements Engineering in the Causes of Safety-Critical Software Failures  

NASA Technical Reports Server (NTRS)

Many software failures stem from inadequate requirements engineering. This view has been supported both by detailed accident investigations and by a number of empirical studies; however, such investigations can be misleading. It is often difficult to distinguish between failures in requirements engineering and problems elsewhere in the software development lifecycle. Further pitfalls arise from the assumption that inadequate requirements engineering is a cause of all software related accidents for which the system fails to meet its requirements. This paper identifies some of the problems that have arisen from an undue focus on the role of requirements engineering in the causes of major accidents. The intention is to provoke further debate within the emerging field of forensic software engineering.

Johnson, C. W.; Holloway, C. M.

2006-01-01

205

Resistance of ferroportin to hepcidin binding causes exocrine pancreatic failure and fatal iron overload.  

PubMed

The regulatory axis between the iron hormone hepcidin and its receptor, the iron exporter ferroportin (FPN), is central to iron homeostasis. Mutations preventing hepcidin-mediated degradation of FPN cause systemic iron overload. We have introduced a point mutation (C326S) into the murine Fpn locus, resembling human hereditary hemochromatosis type 4, including elevated plasma iron and ferritin levels, high transferrin saturation, hepatic iron overload, and iron depletion of duodenal enterocytes and reticuloendothelial macrophages. Unlike other mouse models of iron overload, homozygous C326S mice die between 7 and 14 months of age. Pancreatic acinar cells display marked iron accumulation, oxidative damage and degeneration, associated with failure of the exocrine pancreas and severe body weight loss. Rescue experiments reveal iron overload and exocrine pancreatic failure as leading causes of death. This work uncovers the critical importance of the hepcidin-ferroportin regulatory axis for life and unveils the sensitivity of the exocrine pancreas to iron overload. PMID:25100063

Altamura, Sandro; Kessler, Regina; Gröne, Hermann-Josef; Gretz, Norbert; Hentze, Matthias W; Galy, Bruno; Muckenthaler, Martina U

2014-08-01

206

Transthyretin cardiac amyloidosis: an under-diagnosed cause of heart failure  

PubMed Central

Introduction Cardiac amyloidosis is the most common cause of infiltrative cardiomyopathy and is associated with a poor prognosis. Transthyretin cardiac amyloidosis, particularly the type caused by the mutation that replaces the amino acid valine with the amino acid isoleucine at position 122 (Val122Ile), is most common among African- Americans above 65 years of age. Evidence suggests that this mutation is an important, though under-diagnosed, cause of heart failure in this population. Case presentation A 74-year-old African American male with a diagnosis of non-ischemic cardiomyopathy for several years, presented with gradually worsening dyspnea on exertion and lower extremity edema. There is no known cardiac disease in his family. An echocardiogram was done showing a decrease in ejection fraction to 30% from 45% in the span of a year. An endomyocardial biopsy analysis identified transthyretin amyloid with the Val122Ile mutation, confirming the diagnosis of familial transthyretin cardiomyopathy. Discussion Systemic amyloidosis is a group of diseases caused by the deposition of an abnormally folded, insoluble protein that can accumulate in multiple organs causing progressive and irreversible dysfunction. The mutations that most commonly induce variant transthyretin cardiac amyloidosis are Val122Ile, Val30Met and Thr60Ala. The Val122Ile mutation has been found to be present in 3–4% of the African American/Caribbean population. Conclusions Familial amyloid cardiomyopathy is an uncommonly recognized cause of heart failure in the population, and patients may wait several years before accurate diagnosis, risking additional significant irreversible deterioration. Patients that meet the high-risk profile criteria – male gender, age 65 years and older, heart failure symptoms, symmetric left ventricular (LV) hypertrophy, and moderately depressed LV function – should likely undergo additional testing for cardiac amyloidosis. PMID:25432650

Molina O, Gabriela; Judge, Daniel; Campbell, Wayne; Chahal, Harjit; Mugmon, Marc

2014-01-01

207

Respiratory failure from severe organophosphate toxicity due to absorption through the skin.  

PubMed

Organophosphates are the most common group of chemicals involved in poisoning in Sri Lanka. Usually, poisoning is by ingestion for suicidal purposes, although accidental poisoning is not uncommon. Poisoning due to absorption through intact or damaged skin is rare. A 32-year-old man was admitted to a peripheral hospital following assault with a 100-ml bottle of insecticide called Monocrotophos, an organophosphate. He had a 2-in. long laceration just above his left eyebrow and there was spilling of the liquid contained in the bottle over his head and face. The liquid was wiped off but the head or face was not washed. After about 3 h the patient developed symptoms and signs of early organophosphate poisoning which were treated with atropine and pralidoxime. On the 3rd day, while on therapy, the patient developed severe weakness of limbs and respiratory distress needing intubation and assisted ventilation. The patient was transferred to the neurology intensive care unit of the General Hospital, Colombo, on the eighth day. His serum potassium levels were low and an ECG showed prominent U waves in all leads. The plasma cholinesterase levels were within 37.5-50% of normal even on the 20th day indicating severe exposure. PMID:3350449

Peiris, J B; Fernando, R; De Abrew, K

1988-02-01

208

[A case of multiple organ failure with massive intestinal bleeding caused by methicillin-resistant Staphylococcus aureus in a postcystectomy patient--efficacy of mask continuous positive airway pressure training and intraarterial embolization].  

PubMed

A 51-year-old man underwent radical cystectomy with tubeless cutaneous ureterostomy. Methicillin-resistant Staphylococcus aureus (MRSA) enteritis developed postoperatively. MRSA caused critical infections such as pneumonia and sepsis, which subsequently progressed to adult respiratory distress syndrome, massive melena and multiple organ failure. The patient was rescued by intensive management including mask continuous positive airway pressure, systemic vancomycin administration and intraarterial embolization to stop jejunal bleeding. PMID:9546132

Chiba, K; Hirokawa, M; Yumura, Y; Okada, Y; Hashiba, T; Tomoda, T; Abe, H; Ashida, H

1998-02-01

209

Cinnamon bark oil, a potent fungitoxicant against fungi causing respiratory tract mycoses.  

PubMed

Cinnamic aldehyde has been identified as the active fungitoxic constituent of cinnamon (Cinnamomum zeylanicum) bark oil. The fungitoxic properties of the vapours of the oil/active constituent against fungi involved in respiratory tract mycoses, i.e., Aspergillus niger, A. fumigatus, A. nidulans A. flavus, Candida albicans, C. tropicalis, C. pseudotropicalis, and Histoplasma capsulatum, were determined in vitro as minimum inhibitory concentration (MIC), minimum lethal concentration (MLC), inoculum density sustained, and exposure duration for fungicidal action at MIC and higher doses, as well as effect of incubation temperatures on fungitoxicity. It is concluded that these inhalable vapours appear to approach the ideal chemotherapy for respiratory tract mycoses. PMID:8834832

Singh, H B; Srivastava, M; Singh, A B; Srivastava, A K

1995-12-01

210

Intrapleural steroid instillation for multiple organ failure with acute respiratory distress syndrome.  

PubMed

Acute respiratory distress syndrome (ARDS) increases mortality in patients with multiorgan dysfunction syndrome (MODS). This study evaluates the feasibility of intrapleural steroid instillation (IPSI) in patients with ARDS and MODS unresponsive to conventional extracorporeal membrane oxygenation (ECMO). Ninety-two of 467 patients who underwent ECMO between 2005 and 2009 had ARDS, and 30 consecutive adult patients of these 92 patients with severe ARDS and MODS were retrospectively analyzed in this study. Nine of these 30 patients, who did not respond to therapy and whose condition deteriorated, were managed with IPSI. All patients met the inclusion criteria of hemodynamic instability with high catecholamine infusion requirement and 100% oxygen demand in ventilation and ECMO flow. On initial diagnosis of ARDS, no differences in prognostic scorings were observed in patients who underwent conventional treatment (n = 21) and those who underwent IPSI (n = 9). Blood oxygenation, tidal volume, changing in chest radiographic findings, and survival rates were analyzed. The primary outcome was survival until discharge from the hospital. Pulmonary radiographic appearance improved after 3 days of IPSI treatment (P = 0.008); the ratio of arterial partial pressure of oxygen to fraction of inspired oxygen also increased significantly after 5 days of IPSI treatment (P = 0.028). Moreover, the 28-day mortality rate (P = 0.017), 60-day mortality rate (P = 0.003), and survival rate (78% vs. 19%; P = 0.003) significantly improved in patients undergoing IPSI, which therefore appears to be an easily implemented and highly effective treatment for patients with severe ARDS in combination with MODS, particularly in patients who fail to respond to conventional treatment. PMID:24088995

Huang, Pei-Ming; Lin, Tzu-Hsin; Tsai, Pi-Ru; Ko, Wen-Je

2013-11-01

211

Alveolar Type II Cells Escape Stress Failure Caused by Tonic Stretch through Transient Focal Adhesion Disassembly  

PubMed Central

Mechanical ventilation-induced excessive stretch of alveoli is reported to induce cellular stress failure and subsequent lung injury, and is therefore an injurious factor to the lung. Avoiding cellular stress failure is crucial to ventilator-induced lung injury (VILI) treatment. In the present study, primary rat alveolar type II (ATII) cells were isolated to evaluate their viability and the mechanism of their survival under tonic stretch. By the annexin V/ PI staining and flow cytometry assay, we demonstrated that tonic stretch-induced cell death is an immediate injury of mechanical stress. In addition, immunofluorescence and immunoblots assay showed that the cells experienced an expansion-contraction-reexpansion process, accompanied by partial focal adhesion (FA) disassembly during contraction. Manipulation of integrin adherent affinity by altering bivalent cation levels in the culture medium and applying an integrin neutralizing antibody showed that facilitated adhesion affinity promoted cell death under tonic stretch, while lower level of adhesion protected the cells from stretch-induced stress failure. Finally, a simplified numerical model was established to reveal that adequate disassembly of FAs reduced the forces transmitting throughout the cell. Taken together, these results indicate that ATII cells escape stress failure caused by tonic stretch via active cell morphological remodeling, during which cells transiently disassemble FAs to unload mechanical forces. PMID:21614151

Liu, Xiao-Yang; Chen, Xiao-Fei; Ren, Yan-Hong; Zhan, Qing-Yuan; Wang, Chen; Yang, Chun

2011-01-01

212

Designed for Workarounds: A Qualitative Study of the Causes of Operational Failures in Hospitals  

PubMed Central

Frontline care clinicians and staff in hospitals spend at least 10% of their time working around operational failures: situations in which information, supplies, or equipment needed for patient care are insufficient. However, little is known about underlying causes of operational failures and what hospitals can do to reduce their occurrence. To address this gap, we examined the internal supply chains at 2 hospitals with the aim of discovering organizational factors that contribute to operational failures. We conducted in-depth qualitative research, including observations and interviews of more than 80 individuals from 4 nursing units and the ancillary support departments that provide equipment and supplies needed for patient care. We found that a lack of interconnectedness among interdependent departments’ routines was a major source of operational failures. The low levels of interconnectedness occurred because of how the internal supply chains were designed and managed rather than because of employee error or a shortfall in training. Thus, we propose that the time that hospital staff members spend on workarounds can be reduced through deliberate efforts to increase interconnectedness among hospitals’ internal supply departments. Four dimensions of interconnectedness include: 1) hospital-level—rather than department-level—performance measures; 2) internal supply department routines that respond to specific patients’ needs rather than to predetermined stocking routines; 3) knowledge that is necessary for efficient handoffs of materials that is translated across departmental boundaries; and 4) cross-departmental collaboration mechanisms that enable improvement in the flow of materials across departmental boundaries. PMID:25102517

Tucker, Anita L; Heisler, W Scott; Janisse, Laura D

2014-01-01

213

Analysis of causes that led to Evyn Vaughn's respiratory arrest, intracranial and retinal bleeding, and death  

Microsoft Academic Search

Evyn, a 14-month-old male, suffered from respiratory arrest on April 21, 2007, and was taken to the Northwest Texas Hospital. He was treated with several medications but he did not show an improvement. He was pronounced brain dead on April 22. Evyn was given heparin (3600 units IV) and his major organs were harvested for donations. At autopsy, the medical

Mohammed Ali Al-Bayati

214

Upper respiratory tract infection caused by Cryptosporidium baileyi in three mixed bred falcons  

Microsoft Academic Search

Three mixed-bred raptors (Falco rusticolus × Falco cherrug) from a German falcon breeder were presented with a history of respiratory distress. In one bird a laryngeal stridor was noted, and oral examination revealed an epiglottal swelling. In the other two birds, nasal discharge and sneezing were the main clinical symptoms. Nasal flushing samples and biopsies were collected for pathologic, bacteriologic,

Y. R. A. van Zeeland; N. J. Schoemaker; M. J. L. Kik

2008-01-01

215

Upper Respiratory Tract Disease in the Gopher Tortoise Is Caused by Mycoplasma agassizii  

Microsoft Academic Search

Upper respiratory tract disease (URTD) has been observed in a number of tortoise species, including the desert tortoise (Gopherus agassizii) and the gopher tortoise (Gopherus polyphemus). Clinical signs of URTD in gopher tortoises are similar to those in desert tortoises and include serous, mucoid, or purulent discharge from the nares, excessive tearing to purulent ocular discharge, conjunctivitis, and edema of

M. B. BROWN; G. S. M CLAUGHLIN; P. A. KLEIN; B. C. CRENSHAW

1999-01-01

216

Alveolar Macrophages Are Essential for Protection from Respiratory Failure and Associated Morbidity following Influenza Virus Infection  

PubMed Central

Alveolar macrophages (AM) are critical for defense against bacterial and fungal infections. However, a definitive role of AM in viral infections remains unclear. We here report that AM play a key role in survival to influenza and vaccinia virus infection by maintaining lung function and thereby protecting from asphyxiation. Absence of AM in GM-CSF-deficient (Csf2?/?) mice or selective AM depletion in wild-type mice resulted in impaired gas exchange and fatal hypoxia associated with severe morbidity to influenza virus infection, while viral clearance was affected moderately. Virus-induced morbidity was far more severe in Csf2?/? mice lacking AM, as compared to Batf3-deficient mice lacking CD8?+ and CD103+ DCs. Csf2?/? mice showed intact anti-viral CD8+ T cell responses despite slightly impaired CD103+ DC development. Importantly, selective reconstitution of AM development in Csf2rb?/? mice by neonatal transfer of wild-type AM progenitors prevented severe morbidity and mortality, demonstrating that absence of AM alone is responsible for disease severity in mice lacking GM-CSF or its receptor. In addition, CD11c-Cre/Ppargfl/fl mice with a defect in AM but normal adaptive immunity showed increased morbidity and lung failure to influenza virus. Taken together, our results suggest a superior role of AM compared to CD103+ DCs in protection from acute influenza and vaccinia virus infection-induced morbidity and mortality. PMID:24699679

Schneider, Christoph; Nobs, Samuel P.; Heer, Alex K.; Kurrer, Michael; Klinke, Glynis; van Rooijen, Nico; Vogel, Johannes; Kopf, Manfred

2014-01-01

217

Leptospirosis: An Unusual Cause of ARDS  

PubMed Central

Severe leptospirosis usually associates shock, jaundice, renal failure, and thrombocytopenia. Massive hemoptysis due to diffuse alveolar haemorrhage may rarely occur leading to an acute respiratory failure and multiple organ failure. We present the case of an acute respiratory distress syndrome caused by a severe leptospirosis. The severity of the respiratory failure contrasted with the absence of significant liver or renal dysfunction. Bedside open lung biopsy was only consistent with a postinfectious BOOP. The diagnosis was retrospective when the niece of the patient presented with similar inaugural symptoms ten days later after being scratched by a wild rat which was considered by our patient as a pet. PMID:20981324

Clavel, Marc; Lhéritier, Gwenaelle; Weinbreck, Nicolas; Guerlin, Antoine; Dugard, Anthony; Denes, Eric; Vignon, Philippe

2010-01-01

218

Complex bladder-exstrophy-epispadias management: causes of failure of initial bladder closure.  

PubMed

The success of the initial closure of the complex bladder-exstrophy remains a challenge in pediatric surgery. This study describes a personal experience of the causes of failure of the initial closure and operative morbidity during the surgical treatment of bladder-exstrophy complex. From April 2000 to March 2014, four patients aged 16 days to 7 years and 5 months underwent complex exstrophy-epispadias repair with pelvic osteotomies. There were three males and one female. Three of them had posterior pelvic osteotomy, one had anterior innominate osteotomy. Bladder Closure: Bladder closure was performed in three layers. Our first patient had initial bladder closure with polyglactin 4/0 (Vicryl ® 4/0), concerning the last three patients, initial bladder closure was performed with polydioxanone 4/0 (PDS ® 4/0). The bladder was repaired leaving the urethral stent and ureteral stents for full urinary drainage for three patients. In one case, only urethral stent was left, ureteral drainage was not possible, because stents sizes were more important than the ureteral diameter. Out of a total of four patients, initial bladder closure was completely achieved for three patients. At the immediate postoperative follow-up, two patients presented a complete disunion of the abdominal wall and bladder despite an appropriate postoperative care. The absorbable braided silk (polyglactin) used for the bladder closure was considered as the main factor in the failure of the bladder closure. The second cause of failure of the initial bladder closure was the incomplete urine drainage, ureteral catheterisation was not possible because the catheters sizes were too large compared with the diameters of the ureters. The failure of the initial bladder-exstrophy closure may be reduced by a closure with an absorbable monofilament silk and efficient urine drainage via ureteral catheterisation. PMID:25323185

Bertin, Kouame Dibi; Serge, Kouame Yapo Guy; Moufidath, Sounkere; Maxime, Koffi; Hervé, Odehouri Koudou Thierry; Baptiste, Yaokreh Jean; Samba, Tembely; Gaudens, Dieth Atafi; Ossenou, Ouattara; Ruffin, Dick

2014-01-01

219

Full-genome analysis of a canine pneumovirus causing acute respiratory disease in dogs, Italy.  

PubMed

An outbreak of canine infectious respiratory disease (CIRD) associated to canine pneumovirus (CnPnV) infection is reported. The outbreak occurred in a shelter of the Apulia region and involved 37 out of 350 dogs that displayed cough and/or nasal discharge with no evidence of fever. The full-genomic characterisation showed that the causative agent (strain Bari/100-12) was closely related to CnPnVs that have been recently isolated in the USA, as well as to murine pneumovirus, which is responsible for respiratory disease in mice. The present study represents a useful contribution to the knowledge of the pathogenic potential of CnPnV and its association with CIRD in dogs. Further studies will elucidate the pathogenicity and epidemiology of this novel pneumovirus, thus addressing the eventual need for specific vaccines. PMID:24400129

Decaro, Nicola; Pinto, Pierfrancesco; Mari, Viviana; Elia, Gabriella; Larocca, Vittorio; Camero, Michele; Terio, Valentina; Losurdo, Michele; Martella, Vito; Buonavoglia, Canio

2014-01-01

220

Full-Genome Analysis of a Canine Pneumovirus Causing Acute Respiratory Disease in Dogs, Italy  

PubMed Central

An outbreak of canine infectious respiratory disease (CIRD) associated to canine pneumovirus (CnPnV) infection is reported. The outbreak occurred in a shelter of the Apulia region and involved 37 out of 350 dogs that displayed cough and/or nasal discharge with no evidence of fever. The full-genomic characterisation showed that the causative agent (strain Bari/100-12) was closely related to CnPnVs that have been recently isolated in the USA, as well as to murine pneumovirus, which is responsible for respiratory disease in mice. The present study represents a useful contribution to the knowledge of the pathogenic potential of CnPnV and its association with CIRD in dogs. Further studies will elucidate the pathogenicity and epidemiology of this novel pneumovirus, thus addressing the eventual need for specific vaccines. PMID:24400129

Decaro, Nicola; Pinto, Pierfrancesco; Mari, Viviana; Elia, Gabriella; Larocca, Vittorio; Camero, Michele; Terio, Valentina; Losurdo, Michele; Martella, Vito; Buonavoglia, Canio

2014-01-01

221

Stevens-Johnson syndrome, respiratory distress and acute renal failure due to synergic bleomycin-cisplatin toxicity.  

PubMed

A patient presenting with a cervix uteri epidermoid carcinoma had acute renal failure after treatment with cisplatin and bleomycin. She later developed fatal bleomycin-induced pneumonitis and Stevens-Johnson syndrome. This is a very rare association of adverse effects. The risk of causing a drug interaction thus increasing the severity of bleomycin undesired effects must be taken into account when a nephrotoxic drug is added to the former. The authors stress the importance of monitoring renal function under these conditions. PMID:2478592

Brodsky, A; Aparici, I; Argeri, C; Goldenberg, D

1989-09-01

222

Recurrent respiratory infections caused by a double aortic arch: The diagnostic role of spirometry  

PubMed Central

A young woman with a clinical history characterized by recurrent respiratory infections, occurring since early infancy, was referred to our hospital. When the patient was a young girl, she underwent sweat chloride test, serum analysis of immunoglobulins, and evaluation of blood lymphocyte subsets; all these diagnostic tests were normal, as well as chest X ray aside from pneumonia episodes. Skin prick tests were positive for several different allergens, and a diagnosis of allergic rhinitis was made. At the age of 11 years, she started to complain of gastroesophageal reflux disease (GERD) symptoms, and a gastroscopy detected a hiatal hernia with esophagitis. Despite pharmacologic treatments for allergic rhinitis and GERD, the patient continued to complain of chronic cough, associated with choking and recurrent respiratory infections treated with antibiotic therapy. For the first time in her life, we performed a spirometry that showed a flow-volume curve characterized by a plateau in the expiratory phase, suggestive of an central airway obstruction. Bronchoscopy demonstrated a compression of the distal portion of trachea. Computed tomography (CT) angiogram revealed a double aortic arch. Barium enhancement evidenced an esophageal compression. A surgical division of the smaller of the two arches was then performed. Therefore, we strongly suggest to perform lung function tests in all cases of unexplained respiratory complaints.

Calabrese, Cecilia; Corcione, Nadia; Di Spirito, Valentina; Guarino, Carmine; Rossi, Giovanni; Domenico Gargiulo, Gaetano; Vatrella, Alessandro

2013-01-01

223

ECHS1 Mutations Cause Combined Respiratory Chain Deficiency Resulting in Leigh Syndrome.  

PubMed

The human ECHS1 gene encodes the short-chain enoyl coenzyme A hydratase, the enzyme that catalyzes the second step of ?-oxidation of fatty acids in the mitochondrial matrix. We report on a boy with ECHS1 deficiency who was diagnosed with Leigh syndrome at 21 months of age. The patient presented with hypotonia, metabolic acidosis, and developmental delay. A combined respiratory chain deficiency was also observed. Targeted exome sequencing of 776 mitochondria-associated genes encoded by nuclear DNA identified compound heterozygous mutations in ECHS1. ECHS1 protein expression was severely depleted in the patient's skeletal muscle and patient-derived myoblasts; a marked decrease in enzyme activity was also evident in patient-derived myoblasts. Immortalized patient-derived myoblasts that expressed exogenous wild-type ECHS1 exhibited the recovery of the ECHS1 activity, indicating that the gene defect was pathogenic. Mitochondrial respiratory complex activity was also mostly restored in these cells, suggesting that there was an unidentified link between deficiency of ECHS1 and respiratory chain. Here, we describe the patient with ECHS1 deficiency; these findings will advance our understanding not only the pathology of mitochondrial fatty acid ?-oxidation disorders, but also the regulation of mitochondrial metabolism. PMID:25393721

Sakai, Chika; Yamaguchi, Seiji; Sasaki, Masayuki; Miyamoto, Yusaku; Matsushima, Yuichi; Goto, Yu-Ichi

2015-02-01

224

New disease allele and de novo mutation indicate mutational vulnerability of titin exon 343 in hereditary myopathy with early respiratory failure.  

PubMed

We report two patients of Chinese ancestry with hereditary myopathy with early respiratory failure, one sporadic with atypical onset as rigid spine syndrome, the other familial with 10 years' history of hyperCKemia. Muscle biopsy was either nonspecific or typical with cytoplasmic bodies and rimmed vacuoles. Despite the phenotypic variety, both patients showed fatty infiltration of semitendinosus on muscle magnetic resonance imaging. Genetic analysis of case 1 disclosed de novo heterozygous missense mutations in the 119th fibronectin 3 domain of titin [c.90272C>T, p.P30091L]. Haplotype analysis of case 2 revealed a heterozygous missense mutation [c.90211T>C, p.C30071R] on a new disease allele incompatible with the British common haplotype. These findings suggest that hereditary myopathy with early respiratory failure is a worldwide distributed disorder and indicate the mutational vulnerability of TTN exon 343 in which de novo mutations could occur on different haplotype backgrounds. PMID:25500009

Yue, Dongyue; Gao, Mingshi; Zhu, Wenhua; Luo, Sushan; Xi, Jianying; Wang, Bei; Li, Ying; Cai, Shuang; Li, Jin; Wang, Yin; Lu, Jiahong; Zhao, Chongbo

2015-02-01

225

Acute renal failure caused by bilateral ureteral herniation through the sciatic foramen.  

PubMed

Ureteral herniation is rare. Only a few cases of bilateral ureterosciatic herniation have been reported. We report the case of a 74-year-old woman with flank pain and acute renal failure. The initial ultrasound scan showed bilateral hydronephrosis. Follow-up computed tomography imaging demonstrated sciatic herniation of both ureters, causing bilateral hydronephrosis and hydroureter. The patient underwent bilateral retrograde ureterography and ureteral stent placement, with improvement in renal function to normal limits. Observation after stent removal demonstrated recurrent sciatic herniation of both ureters. Definitive surgical correction was performed by way of laparoscopic bilateral ureterolysis and sciatic notch hernia repair using mesh. PMID:23602799

Whyburn, James J; Alizadeh, Ahmadreza

2013-06-01

226

Respiratory Viral Infection in Neonatal Piglets Causes Marked Microglia Activation in the Hippocampus and Deficits in Spatial Learning  

PubMed Central

Environmental insults during sensitive periods can affect hippocampal development and function, but little is known about peripheral infection, especially in humans and other animals whose brain is gyrencephalic and experiences major perinatal growth. Using a piglet model, the present study showed that inoculation on postnatal day 7 with the porcine reproductive and respiratory syndrome virus (PRRSV) caused microglial activation within the hippocampus with 82% and 43% of isolated microglia being MHC II+ 13 and 20 d after inoculation, respectively. In control piglets, <5% of microglia isolated from the hippocampus were MHC II+. PRRSV piglets were febrile (p < 0.0001), anorectic (p < 0.0001), and weighed less at the end of the study (p = 0.002) compared with control piglets. Increased inflammatory gene expression (e.g., IL-1?, IL-6, TNF-?, and IFN-?) was seen across multiple brain regions, including the hippocampus, whereas reductions in CD200, NGF, and MBP were evident. In a test of spatial learning, PRRSV piglets took longer to acquire the task, had a longer latency to choice, and had a higher total distance moved. Overall, these data demonstrate that viral respiratory infection is associated with a marked increase in activated microglia in the hippocampus, neuroinflammation, and impaired performance in a spatial cognitive task. As respiratory infections are common in human neonates and infants, approaches to regulate microglial cell activity are likely to be important. PMID:24501353

Elmore, Monica R. P.; Burton, Michael D.; Conrad, Matthew S.; Rytych, Jennifer L.; Van Alstine, William G.

2014-01-01

227

Health-related quality of life and long-term prognosis in chronic hypercapnic respiratory failure: a prospective survival analysis  

PubMed Central

Background Health-related quality of life (HRQL) is considered as an important outcome parameter in patients with chronic diseases. This study aimed to assess the role of disease-specific HRQL for long-term survival in patients of different diagnoses with chronic hypercapnic respiratory failure (CHRF). Methods In a cohort of 231 stable patients (chronic obstructive pulmonary disease (COPD), n = 98; non-COPD (obesity-hypoventilation syndrome, restrictive disorders, neuromuscular disorders), n = 133) with CHRF and current home mechanical ventilation (HMV), HRQL was assessed by the disease-specific Severe Respiratory Insufficiency (SRI) questionnaire and its prognostic value was prospectively evaluated during a follow-up of 2–4 years, using univariate and multivariate regression analysis. Results HRQL was more impaired in COPD (mean ± SD SRI-summary score (SRI-SS) 52.5 ± 15.6) than non-COPD patients (67.6 ± 16.4; p < 0.001). Overall mortality during 28.9 ± 8.8 months of follow-up was 19.1% (31.6% in COPD, 9.8% in non-COPD). To identify the overall role of SRI, we first evaluated the total study population. SRI-SS and its subdomains (except attendance symptoms and sleep), as well as body mass index (BMI), leukocyte number and spirometric indices were associated with long-term survival (p < 0.01 each). Of these, SRI-SS, leukocytes and forced expiratory volume in 1 s (FEV1) turned out to be independent predictors (p < 0.05 each). More specifically, in non-COPD patients SRI-SS and most of its subdomains, as well as leukocyte number, were related to survival (p < 0.05), whereas in patients with COPD only BMI and lung function but not SRI were predictive. Conclusion In patients with CHRF and HMV, the disease-specific SRI was an overall predictor of long-term survival in addition to established risk factors. However, the SRI predominantly beared information regarding long-term survival in non-COPD patients, while in COPD patients objective measures of the disease state were superior. This on one hand highlights the significance of HRQL in the long-term course of patients with CHRF, on the other hand it suggests that the predictive value of HRQL depends on the underlying disease. PMID:18086309

Budweiser, Stephan; Hitzl, Andre P; Jörres, Rudolf A; Schmidbauer, Kathrin; Heinemann, Frank; Pfeifer, Michael

2007-01-01

228

Hitch-hiker taken for a ride: an unusual cause of myocarditis, septic shock and adult respiratory distress syndrome.  

PubMed

Rocky Mountain spotted fever (RMSF) is a serious tick-borne illness caused by Rickettsia rickettsii that is endemic in southeastern USA. Although RMSF has been described as causing the classic clinical triad of fever, headache and a characteristic rash, serious and potentially life-threatening manifestations can occur. Cardiopulmonary involvement, although infrequent, may occur with severe cases of RMSF. Rickettsial myocarditis is an uncommon occurrence. We present a case of a previously healthy 26-year-old man, who was hitch-hiking across the southeastern USA, with serologically proven RMSF causing adult respiratory distress syndrome, septic shock and myocarditis manifested by elevated cardiac enzymes and decrease in myocardial function. After treatment with antibiotics, the myocarditis resolved. Therefore, although unusual, clinicians should be aware of possible myocardial involvement in patients with appropriate tick-exposure histories or other clinical signs of RMSF. PMID:23314875

Kushawaha, Anurag; Brown, Mark; Martin, Ismael; Evenhuis, Walther

2013-01-01

229

Hitch-hiker taken for a ride: an unusual cause of myocarditis, septic shock and adult respiratory distress syndrome  

PubMed Central

Rocky Mountain spotted fever (RMSF) is a serious tick-borne illness caused by Rickettsia rickettsii that is endemic in southeastern USA. Although RMSF has been described as causing the classic clinical triad of fever, headache and a characteristic rash, serious and potentially life-threatening manifestations can occur. Cardiopulmonary involvement, although infrequent, may occur with severe cases of RMSF. Rickettsial myocarditis is an uncommon occurrence. We present a case of a previously healthy 26-year-old man, who was hitch-hiking across the southeastern USA, with serologically proven RMSF causing adult respiratory distress syndrome, septic shock and myocarditis manifested by elevated cardiac enzymes and decrease in myocardial function. After treatment with antibiotics, the myocarditis resolved. Therefore, although unusual, clinicians should be aware of possible myocardial involvement in patients with appropriate tick-exposure histories or other clinical signs of RMSF. PMID:23314875

Kushawaha, Anurag; Brown, Mark; Martin, Ismael; Evenhuis, Walther

2013-01-01

230

Proteins of the cystic fibrosis respiratory tract. Fragmented immunoglobulin G opsonic antibody causing defective opsonophagocytosis.  

PubMed Central

In the disease cystic fibrosis (CF), pulmonary infection with Pseudomonas aeruginosa is a common clinical complication that determines most morbidity and almost all excess mortality. We postulated that in this disease a defect in Pseudomonas-reactive IgG antibodies may contribute to chronic Pseudomonas infections. Bronchoalveolar lavages were performed upon 13 patients with CF, 7 patients with chronic bronchitis characterized by recurrent Pseudomonas infections, and 4 normal volunteers. The levels of various proteins important to host defenses and proteases were determined; enzyme inhibition studies were performed. CF respiratory immunoglobulin levels were significantly elevated when compared with both normals and patients with chronic bronchitis (P less than 0.05). Albumin and transferrin levels were decreased in the CF lung fluids. CF elastolytic activity was strikingly elevated (means = 6.02 micrograms/mg total protein) and the inhibitory profile suggested such activity resembled a serine-proteinase. Alpha-1-antitrypsin antigenic levels were not altered in CF respiratory fluids. There was a tendency for the lavage IgG to fall as elastase levels rose (r = -0.29). IgG opsonins for two Pseudomonas immunotypes were isolated with affinity chromatography for functional and immunochemical studies. Bacterial phagocytic rates in the presence of these Pseudomonas-reactive IgG opsonins derived from CF lavage fluid were depressed (0.3% uptake/unit time) when compared with similarly titered positive controls (uptake = 1.3%/unit time, P less than 0.001). Additionally, normal pulmonary macrophage intracellular killing of Pseudomonas was severely altered in the presence of opsonins derived from CF respiratory fluids. At some time points, less than 30% of the bacteria were killed. CF IgG opsonins contain a cleavage fragment (100,000 D, 5S sedimentation coefficient) with antigenic determinants similar to the Fab portion of IgG. The presence of such a fragment was inversely correlated with phagocytic functional activity. Intact IgG comprised as little as 18% of the CF lavage fluid specimens. Aliquots of intact human IgG, when mixed with the CF opsonins, augmented Pseudomonas uptake and improved intracellular killing. Conversely, peptide fragments of IgG opsonins, which are proteolytically derived in vitro, duplicated in our system the defect observed with opsonins derived from CF lung fluids; bacterial uptake was inversely related to the concentration of F(ab')2 and to a greater degree, to Fc present in the opsonic mixture. We concluded that IgG respiratory opsonins are fragmented, inhibiting phagocytosis and serving a permissive role in the chronic Pseudomonas pulmonary infection in the disease CF. Images PMID:6429195

Fick, R B; Naegel, G P; Squier, S U; Wood, R E; Gee, J B; Reynolds, H Y

1984-01-01

231

Familial mixed nephrocalcinosis as a cause of chronic kidney failure: two case reports  

PubMed Central

Introduction Nephrocalcinosis consists of the deposition of calcium salts in the renal parenchyma and is considered the mixed form when it involves the renal cortex and medulla. The main etiological agents of this condition are primary hyperparathyroidism, renal tubular acidosis, medullary sponge kidney, hyperoxaluria and taking certain drugs. These factors can lead to hypercalcemia and/or hypercalciuria, which can give rise to nephrocalcinosis. Case presentations Patient 1 was a 48-year-old Caucasian woman with a history of bilateral nephrocalcinosis causing chronic kidney failure. Imaging examinations (X-ray, ultrasound and computed tomography of the abdomen) revealed extensive calcium deposits in the renal parenchyma, indicating nephrocalcinosis as the causal factor of the disease. Patient 2 is the 45-year-old brother of patient 1. He exhibited an advanced stage of chronic kidney failure. As nephrocalcinosis is considered to have a genetic component, a family investigation revealed this condition in patient 2. Conclusion Nephrocalcinosis may be detected incidentally through diagnostic imaging studies. Whenever possible, treatment should include the base disease that caused the appearance of the calcification, as the precise etiological determination is extremely important. PMID:25346103

2014-01-01

232

Muscle specific kinase autoantibodies cause synaptic failure through progressive wastage of postsynaptic acetylcholine receptors.  

PubMed

In myasthenia gravis muscle weakness is caused by autoantibodies against components of the neuromuscular junction. Patient autoantibodies against muscle specific kinase (MuSK) deplete MuSK from the postsynaptic membrane and reproduce signs of myasthenia gravis when injected into mice. Here we have examined the time-course of structural and functional changes that lead up to synaptic failure. C57Bl6J mice received daily injections of anti-MuSK patient IgG for 15 days. Mice began to lose weight from day 12 and demonstrated whole-body weakness by day 14. Electromyography indicated synaptic impairment from day 6 in the gastrocnemius muscle and from day 10 in the diaphragm muscle. Confocal microscopy revealed linear declines in the area and density of postsynaptic acetylcholine receptors (3-5% per day) from day 1 through day 15 of the injection series in all five muscles examined. Intracellular recordings from the diaphragm muscle revealed comparable progressive declines in the amplitude of the endplate potential and miniature endplate potential of 3-4% per day. Neither quantal content nor the postsynaptic action potential threshold changed significantly over the injection series. The inverse relationship between the quantal amplitude of a synapse and its quantal content disappeared only late in the injection series (day 10). Our results suggest that the primary myasthenogenic action of anti-MuSK IgG is to cause wastage of postsynaptic acetylcholine receptor density. Consequent reductions in endplate potential amplitudes culminated in failure of neuromuscular transmission. PMID:22789393

Morsch, Marco; Reddel, Stephen W; Ghazanfari, Nazanin; Toyka, Klaus V; Phillips, William D

2012-10-01

233

Signal failure of type 2 comprehensive unattended sleep studies in patients with suspected respiratory sleep disordered breathing  

Microsoft Academic Search

We designed this study to assess the signal failure and sensor loss of unattended type 2 comprehensive polysomnography (PSG) and compared that with in-lab attended PSG. Type 2 PSG was performed for 41 patients. The signal failure was estimated and compared to the signal failure in 60 patients for the in-lab PSGs. The signal failure in each individual electroencephalographic (EEG)

Ahmed S. BaHammam

2005-01-01

234

Legionella pneumonia associated with adult respiratory distress syndrome caused by Legionella pneumophila serogroup 3.  

PubMed

A 68-year-old man developed pneumonia 2 days after nearly drowning in a bathtub of a hot spring spa. Chest radiography revealed bilateral consolidation shadows associated with adult respiratory distress syndrome. Initial treatment with antibiotics and pulse therapy with methylprednisolone was not effective. The patient died on the 4th hospital day. A urinary antigen test for Legionella was positive. Legionella pneumophila serogroup 3 was recovered from an intratracheal specimen. The same serotype of Legionella was isolated from the hot spring water. Restriction enzyme analysis by pulse-field gel electrophoresis revealed identical restriction fragments. We conclude that the water at the hot spring spa could have been the source of infection. PMID:15704668

Nozue, Tsuyoshi; Chikazawa, Hiroo; Miyanishi, Shuji; Shimazaki, Takeo; Oka, Rie; Shimazaki, Seikou; Miyamoto, Susumu

2005-01-01

235

Nest success, cause-specific nest failure, and hatchability of aquatic birds at selenium-contaminated Kesterson Reservoir and a reference site  

USGS Publications Warehouse

Nest success and causes of failure varied by species, site, and year. The most important causes of nest failure were predation, desertion, and water level changes. Embryotoxicity was the most important cause of nest failure in eared grebes at Kesterson Reservoir.

Ohlendorf, H.M.; Hothem, R.L.; Welsh, D.

1989-01-01

236

Causes of failure with Szabo technique – An analysis of nine cases  

PubMed Central

Objective The objective of this case series is to identify and define causes of failure of Szabo technique in rapid-exchange monorail system for ostial lesions. Methods and results From March 2009 to March 2011, 42 patients with an ostial lesion were treated percutaneously at our institution using Szabo technique in a monorail stent system. All patients received unfractionated heparin during intervention. Loading dose of clopidogrel, followed by clopidogrel and aspirin was administered. In 57% of patients, drug-eluting stents were used and in 42.8% patients bare metal stents. The stent was advanced over both wires, the target wire and the anchor wire. The anchor wire, which was passed through the proximal trailing strut of the stent helps to achieve precise stenting. The procedure was considered to be successful if stent was placed precisely covering the lesion and without stent loss or anchor wire prolapsing. Of the total 42 patients, the procedure was successful in 33, while failed in 9. Majority of failures were due to wire entanglement, which was fixed successfully in 3 cases by removing and reinserting the anchor wire. Out of other three failures, in one stent dislodgment occurred, stent could not cross the lesion in one and in another anchor wire got looped and prolapsed into target vessel. Conclusion This case series shows that the Szabo technique, in spite of some difficulties like wire entanglement, stent dislodgement and resistance during stent advancement, is a simple and feasible method for treating variety of ostial lesions precisely compared to conventional angioplasty. PMID:23809379

Jain, Rajendra Kumar; Padmanabhan, T.N.C.; Chitnis, Nishad

2013-01-01

237

Living with Respiratory Failure  

MedlinePLUS

... fire. In the presence of oxygen, a small fire can quickly get out of control. Also, the cylinder that compressed oxygen gas comes in can explode when exposed to heat. For more information about how to quit smoking, go to the ...

238

Nasal high–flow oxygen therapy in patients with hypoxic respiratory failure: effect on functional and subjective respiratory parameters compared to conventional oxygen therapy and non-invasive ventilation (NIV)  

PubMed Central

Background Aim of the study was to compare the short-term effects of oxygen therapy via a high-flow nasal cannula (HFNC) on functional and subjective respiratory parameters in patients with acute hypoxic respiratory failure in comparison to non-invasive ventilation (NIV) and standard treatment via a Venturi mask. Methods Fourteen patients with acute hypoxic respiratory failure were treated with HFNC (FiO2 0.6, gas flow 55 l/min), NIV (FiO2 0.6, PEEP 5 cm H2O Hg, tidal volume 6–8 ml/kg ideal body weight,) and Venturi mask (FiO2 0.6, oxygen flow 15 l/min,) in a randomized order for 30 min each. Data collection included objective respiratory and circulatory parameters as well as a subjective rating of dyspnea and discomfort by the patients on a 10-point scale. In a final interview, all three methods were comparatively evaluated by each patient using a scale from 1 (=very good) to 6 (=failed) and the patients were asked to choose one method for further treatment. Results PaO2 was highest under NIV (129 ± 38 mmHg) compared to HFNC (101 ± 34 mmHg, p <0.01 vs. NIV) and VM (85 ± 21 mmHg, p <0.001 vs. NIV, p <0.01 vs. HFNC, ANOVA). All other functional parameters showed no relevant differences. In contrast, dyspnea was significantly better using a HFNC (2.9 ± 2.1, 10-point Borg scale) compared to NIV (5.0 ± 3.3, p <0.05), whereas dyspnea rating under HFNC and VM (3.3 ± 2.3) was not significantly different. A similar pattern was found when patients rated their overall discomfort on the 10 point scale: HFNC 2.7 ± 1.8, VM 3.1 ± 2.8 (ns vs. HFNC), NIV 5.4 ± 3.1 (p <0.05 vs. HFNC). In the final evaluation patients gave the best ratings to HFNC 2.3 ± 1.4, followed by VM 3.2 ± 1.7 (ns vs. HFNC) and NIV 4.5 ± 1.7 (p <0.01 vs. HFNC and p <0.05 vs. VM). For further treatment 10 patients chose HFNC, three VM and one NIV. Conclusions In hypoxic respiratory failure HFNC offers a good balance between oxygenation and comfort compared to NIV and Venturi mask and seems to be well tolerated by patients. Trial registration German clinical trials register: DRKS00005132. PMID:25110463

2014-01-01

239

Angiodysplasia as a cause of severe hematochezia in a child with end-stage renal failure.  

PubMed

Angiodysplasia is a frequent cause of gastrointestinal bleeding in adults with chronic renal failure (CRF); however, there is no data about this association in children. The mechanism of this association is not known. We report a 4.5-year-old boy with CRF presenting with hematochezia due to colonic angiodysplasia. He was on hemodialysis for the previous 9 months. Treatment with argon plasma coagulation (APC) was commenced following a short course of octreotide therapy. During the 3 years of follow-up, no occult or gross bleeding occurred. This case illustrates that octreotide and APC therapy seems to be useful for arresting bleeding from angiodysplasia and prevention of recurrent bleeding in children with CRF. PMID:21332351

Kulo?lu, Zarife; Özçakar, Zeynep Birsin; Kansu, Aydan; Üstünda?, Gonca; Ekim, Mesiha; Altugan, F ?emsa; Kendirli, Tan?l; Ç?nar, Kubilay; Yalç?nkaya, Fato?

2011-01-01

240

A partial failure of membrane protein turnover may cause Alzheimer's disease: a new hypothesis.  

PubMed

The amyloid hypothesis has dominated the thinking in our attempts to understand, diagnose and develop drugs for Alzheimer's disease (AD). This article presents a new hypothesis that takes into account the numerous familial AD (FAD) mutations in the amyloid precursor protein (APP) and its processing pathways, but suggests a new perspective beyond toxicity of forms of the amyloid beta-peptide (Abeta). Clearly, amyloid deposits are an invariable feature of AD. Moreover, although APP is normally processed to secreted and membrane-bound fragments, sAPPbeta and CTFbeta, by BACE, and the latter is subsequently processed by gamma-secretase to Abeta and CTFgamma, this pathway mostly yields Abeta of 40 residues, and increases in the levels of the amyloidogenic 42-residue Abeta (Abeta42) are seen in the majority of the mutations linked to the disease. The resulting theory is that the disease is caused by amyloid toxicity, which impairs memory and triggers deposition of the microtubule associated protein, Tau, as neurofibrillary tangles. Nevertheless, a few exceptional FAD mutations and the presence of large amounts of amyloid deposits in a group of cognitively normal elderly patients suggest that the disease process is more complex. Indeed, it has been hard to demonstrate the toxicity of Abeta42 and the actual target has been shifted to small oligomers of the peptide, named Abeta derived diffusible ligands (ADDLs). Our hypothesis is that the disease is more complex and caused by a failure of APP metabolism or clearance, which simultaneously affects several other membrane proteins. Thus, a traffic jam is created by failure of important pathways such as gamma-secretase processing of residual intramembrane domains released from the metabolism of multiple membrane proteins, which ultimately leads to a multiple system failure. In this theory, toxicity of Abeta42 will only contribute partially, if at all, to neurodegeneration in AD. More significantly, this theory would predict that focussing on specific reagents such as gamma-secretase inhibitors that hamper metabolism of APP, may initially show some beneficial effects on cognitive performance by elimination of acutely toxic ADDLs, but over the longer term may exacerbate the disease process by reducing membrane protein turnover. PMID:16472208

Sambamurti, Kumar; Suram, Anitha; Venugopal, Chitra; Prakasam, Annamalai; Zhou, Yan; Lahiri, Debomoy K; Greig, Nigel H

2006-02-01

241

[Headache caused by distortion of the nasal septum and respiratory disturbances of the nasal cavity].  

PubMed

Head and facial pain of unknown origin may be caused by defective aeration of nose and sinus. The reason is a chronic irritation of the mucosa or direct contact between septum and conchal mucosa. A secondary reaction to the impaired breathing through the nose may be an irritation of the sinus without causing a full-grown sinusitis. Diagnosis and therapy are possible by rhinoscopy, sinumanometry and sinuscopy in one appointment. PMID:293046

Wespi, H H; Stojan, V

1979-05-01

242

Serum activin A and B levels predict outcome in patients with acute respiratory failure: a prospective cohort study  

PubMed Central

Introduction 30 day mortality in patients with Acute Respiratory Failure (ARF) is approximately 30%, defined as patients requiring ventilator support for more than 6 hours. Novel biomarkers are needed to predict patient outcomes and to guide potential future therapies. The activins A and B, members of the Transforming Growth Factor ? family of proteins, and their binding protein, follistatin, have recently been shown to be important regulators of inflammation and fibrosis but no substantial data are available concerning their roles in ARF. Our objectives were to evaluate whether the serum levels of activin A, B and follistatin are elevated in 518 patients with ARF from the FINNALI study compared the concentrations in 138 normal subjects that form a reference range. Methods Specific assays for activin A, B and follistatin were used and the results analyzed according to diagnostic groups as well as according to standard measures in intensive care. Multivariable logistic regression was used to create a model to predict death at 90 days and 12 months from the onset of the ARF. Results Serum activin A and B were significantly elevated in most patients and in most of the diagnostic groups. Patients who had activin A and/or B concentrations above the reference maximum were significantly more likely to die in the 12 months following admission [either activin A or B above reference maximum: Positive Likelihood Ratio [LR+] 1.65 [95% CI 1.28-2.12, P?=?0.00013]; both activin A and B above reference maximum: LR?+?2.78 [95% CI 1.96-3.95, P?

2013-01-01

243

Effect of non-invasive mechanical ventilation on sleep and nocturnal ventilation in patients with chronic respiratory failure  

PubMed Central

BACKGROUND—Chronic respiratory failure (CRF) is associated with nocturnal hypoventilation. Due to the interaction of sleep and breathing, sleep quality is reduced during nocturnal hypoventilation. Non-invasive mechanical ventilation (NMV), usually performed overnight, relieves symptoms of hypoventilation and improves daytime blood gas tensions in patients with CRF. The time course of the long term effect of NMV on sleep and breathing during both spontaneous ventilation (withdrawing the intervention) and NMV was investigated in patients with CRF due to thoracic restriction.?METHODS—Fifteen consecutive patients (13 women) of mean (SD) age 57.9 (12.0) years with CRF due to thoracic restriction were included in the study. During the one year observation period four polysomnographic studies were performed: three during spontaneous breathing without NMV—before initiation of NMV (T0) and after withdrawing NMV for one night at six months (T6) and 12 months (T12-)—and the fourth during NMV after 12 months (T12+). Daytime blood gas tensions and lung function were also measured.?RESULTS—Spontaneous ventilation (in terms of mean oxygen saturation) progressively improved (from T0 to T12-) during both REM sleep (24.8%, 95% CI 12.9 to 36.9) and NREM sleep (21.5%, 95% CI 12.4to 30.6). Sleep quality during spontaneous ventilation also improved in terms of increased total sleep time (26.8%, 95% CI 11.6 to 42.0) and sleep efficiency (17.5%, 95% CI 5.4 to 29.6) and decreased awakenings (54.0%, 95% CI 70.3 to 37.7). Accordingly, REM and NREM sleep stages 3 and 4 significantly improved. However, the most significant improvements in both nocturnal ventilation and sleep quality were seen during NMV at 12months.?CONCLUSIONS—After long term NMV both spontaneous ventilation during sleep and sleep quality in patients with CRF due to thoracic restriction showed evidence of progressive improvement compared with baseline after withdrawal of NMV for a single night at six and 12 months. However, the greatest improvements in nocturnal ventilation and sleep were achieved during NMV at 12months.?? PMID:10722771

Schonhofer, B.; Kohler, D.

2000-01-01

244

Upper respiratory tract infection caused by Cryptosporidium baileyi in three mixed-bred falcons (Falco rusticolus x Falco cherrug).  

PubMed

Three mixed-bred raptors (Falco rusticolus x Falco cherrug) from a German falcon breeder were presented with a history of respiratory distress. In one bird a laryngeal stridor was noted, and oral examination revealed an epiglottal swelling. In the other two birds, nasal discharge and sneezing were the main clinical symptoms. Nasal flushing samples and biopsies were collected for pathologic, bacteriologic, and parasitologic examination. Results confirmed a cryptosporidial infection. Polymerase chain reaction (PCR) and DNA analysis identified the causative agent to be Cryptosporidium baileyi. No cryptosporidia were detected in fecal samples, indicating the infection was confined to the respiratory system. Analysis of prey animals (pigeons, quail) failed to identify the source of infection. Treatment was initiated with paromomycin in all three birds, whereas in two birds an additional therapy with azithromycin was given. However, no clinical improvement was seen after several weeks of treatment, and the birds either died or were euthanatized. To the authors' knowledge, these are the first confirmed cases of disease caused by cryptosporidia in the order of Falconiformes. PMID:18646471

van Zeeland, Y R A; Schoemaker, N J; Kik, M J L; van der Giessend, J W B

2008-06-01

245

Acute liver failure caused by 'fat burners' and dietary supplements: a case report and literature review.  

PubMed

Globally, people are struggling with obesity. Many effective, nonconventional methods of weight reduction, such as herbal and natural dietary supplements, are increasingly being sought. Fat burners are believed to raise metabolism, burn more calories and hasten fat loss. Despite patient perceptions that herbal remedies are free of adverse effects, some supplements are associated with severe hepatotoxicity. The present report describes a young healthy woman who presented with fulminant hepatic failure requiring emergent liver transplantation caused by a dietary supplement and fat burner containing usnic acid, green tea and guggul tree extracts. Thorough investigation, including histopathological examination, revealed no other cause of hepatotoxicity. The present case adds to the increasing number of reports of hepatotoxicity associated with dietary supplements containing usnic acid, and highlights that herbal extracts from green tea or guggul tree may not be free of adverse effects. Until these products are more closely regulated and their advertising better scrutinized, physicians and patients should become more familiar with herbal products that are commonly used as weight loss supplements and recognize those that are potentially harmful. PMID:21499580

Yellapu, Radha K; Mittal, Vivek; Grewal, Priya; Fiel, Mariaisabel; Schiano, Thomas

2011-03-01

246

Non-Invasive Ventilation (NIV) and Homeostatic Model Assessment (HOMA) Index in Stable Chronic Obstructive Pulmonary Disease (COPD) Patients with Chronic Hypercapnic Respiratory Failure: A Pilot Study.  

PubMed

Abstract The effects of Non-invasive Ventilation (NIV) on Insulin Resistance (IR) in stable Chronic Obstructive Pulmonary Disease (COPD) patients have not been fully explored. The aim of this study was to assess the effects of NIV on IR and adiponectin levels during one year application of NIV in stable COPD patients with Chronic Hypercapnic Respiratory Failure. Twenty-five (25) stable COPD patients with Chronic Hypercapnic Respiratory Failure and with no self-reported comorbidities completed the study. NIV was administered in the spontaneous/timed mode via a full face mask using a bi-level positive airway pressure system. Spirometry, blood pressure, arterial blood gases, dyspnea, daytime sleepiness, serum fasting glucose and insulin levels were assessed. IR was assessed with the calculation of the Homeostatic Model Assessment (HOMA) index. Adiponectin was measured with radioimmunoassay. Study participants were re-evaluated on the first, third, sixth, ninth and twelfth month after the initial evaluation. There was a significant improvement in FEV1 values from the first month (34.1 ± 11.6% vs 37 ± 12.3%, p = 0.05). There was a significant decrease in IR by the ninth month of NIV use (3.4 ± 2.3 vs 2.2 ± 1.4, p < 0.0001), while adiponectin levels significantly improved from the first month of NIV use. Stepwise regression analysis revealed that baseline HOMA index was associated with paCO2 (? = 0.07 ± 0.02, p = 0.001), while baseline adiponectin levels were associated with FVC (? = 0.05 ± 0.02, p = 0.035) and the concentration of serum bicarbonate (HCO3-) (-? = 0.18 ± 0.06, p = 0.002). Insulin sensitivity and glucose metabolism as well as adiponectin levels improved along with the improvements in respiratory failure. PMID:25415619

Dimoulis, Andreas; Pastaka, Chaido; Tsolaki, Vasiliki; Tsilioni, Irini; Pournaras, Spyridon; Liakos, Nikolaos; Georgoulias, Panagiotis; Gourgoulianis, Konstantinos

2014-11-21

247

Failure to maintain luteal function: a possible cause of early embryonic loss in a cow.  

PubMed Central

The effect of early pregnancy failure on the release of prostaglandin F2 alpha (PGF2 alpha) in response to oxytocin (Ot) was examined in an abnormal breeder (AB) heifer that was not able to maintain a pregnancy beyond 21 days. This animal was used in three experiments: 1) She received one intravenous injection of 100 IU Ot 17 days after the onset of oestrus (Day 0). Frequent blood samples were taken for the measurement of 15-keto-13,14-dihydro-PGF2 alpha (PGFM) by radioimmunoassay. Daily samples for progesterone (P4) determinations were taken to monitor luteal function. This was then repeated using the same animal at either day 17 or 18 or 19 (day 17-19) of pregnancy. 2) Embryos from superovulated normal breeder (NB) donors were transferred at day 7 to the AB heifer as well as to NB control animals. 3) Seven day old embryos from the superovulated AB heifer were transferred to NB recipient animals. At day 17-19 of pregnancy all the recipient heifers (experiments 2 and 3) were subjected to the same protocol as in experiment 1. The results showed that the ability of Ot to stimulate PGF2 alpha release was reduced in the NB recipients bearing viable embryos when compared to cyclic animals. However, for the AB heifer, Ot stimulated PGF2 alpha release to the same extent whether the animal was cyclic or pregnant. Furthermore, the AB animal did not have the extended luteal function associated with removal of viable embryos on day 17-19. The data suggest that the embryonic loss might have been caused by failure of the embryos to prevent the luteolytic release of PGF2 alpha. PMID:2766148

Lafrance, M; Goff, A K; Guay, P; Harvey, D

1989-01-01

248

Acute increase in plasma osmolality as a cause of hyperkalemia in patients with renal failure.  

PubMed

These studies were performed in patients with chronic renal failure to understand the mechanism(s) of hyperkalemia secondary to hypertonic NaCl infusion. In 10 patients, after intravenous infusion of either 5% or 2.5% NaCl (6 mEq per kg body wt for 120 minutes in both solutions), the maximum increase in plasma potassium averaged 0.6 (range 0.3 to 1.3) mmol/liter (P less than 0.01) or 0.3 (range 0.2 to 0.6) mmol/liter (P less than 0.01), respectively. The rise of both plasma potassium and osmolality was significantly higher during 5% NaCl than during 2.5% NaCl infusion (P less than 0.01). A significant linear correlation (P less than 0.01) between plasma potassium and osmolality was observed. Urinary potassium excretion was increased to a similar extent by 5% NaCl and 2.5% NaCl infusion. The observed hyperkalemia, secondary to NaCl infusion, was independent of venous pH, plasma bicarbonate, anion gap, insulin levels, and urinary norepinephrine and epinephrine excretion, and was associated with a fall in plasma aldosterone concentration. In separate studies, nine patients were treated with desoxycorticosterone acetate (DOCA; 20 mg i.m. for three days) before receiving saline (5%) infusion. DOCA did not prevent the level increase in plasma potassium that remained significantly correlated with plasma osmolality (P less than 0.01). In conclusion, hypertonic NaCl infusion in patients with renal failure causes a clinically relevant hyperkalemia despite increased renal excretion of potassium. This hyperkalemia is independent of acid-base or hormonal mechanisms known to regulate extrarenal homeostasis of potassium, and is strictly correlated with a rise in plasma osmolality. PMID:2402122

Conte, G; Dal Canton, A; Imperatore, P; De Nicola, L; Gigliotti, G; Pisanti, N; Memoli, B; Fuiano, G; Esposito, C; Andreucci, V E

1990-08-01

249

Anastomoses of the Ovarian and Uterine Arteries: A Potential Pitfall and Cause of Failure of Uterine Embolization  

SciTech Connect

Four women with symptomatic uterine fibroids were treated by uterine artery embolization (UAE). In all cases both uterine arteries were embolized via a single femoral puncture with polyvinyl alcohol using a selective catheter technique. In three cases, the ovarian artery was not visible on the initial angiogram before embolization, but appeared after the second uterine artery had been treated. In one case of clinical failure following UAE, a repeat angiogram demonstrated filling of the fibroids from the ovarian artery. Anastomoses between uterine and ovarian arteries may cause problems for radiologists performing UAE and are a potential cause of treatment failure.

Matson, Matthew [Department of Radiology, St. George's Hospital, Blackshaw Road, London, SW17 OQT (United Kingdom); Nicholson, Anthony [Department of Radiology, Hull Royal Infirmary, Anlaby Road, Hull HU3 2JZ (United Kingdom); Belli, Anna-Maria [Department of Radiology, St. George's Hospital, Blackshaw Road, London, SW17 OQT (United Kingdom)

2000-09-15

250

Dysautonomia Due to Reduced Cholinergic Neurotransmission Causes Cardiac Remodeling and Heart Failure ? ‡  

PubMed Central

Overwhelming evidence supports the importance of the sympathetic nervous system in heart failure. In contrast, much less is known about the role of failing cholinergic neurotransmission in cardiac disease. By using a unique genetically modified mouse line with reduced expression of the vesicular acetylcholine transporter (VAChT) and consequently decreased release of acetylcholine, we investigated the consequences of altered cholinergic tone for cardiac function. M-mode echocardiography, hemodynamic experiments, analysis of isolated perfused hearts, and measurements of cardiomyocyte contraction indicated that VAChT mutant mice have decreased left ventricle function associated with altered calcium handling. Gene expression was analyzed by quantitative reverse transcriptase PCR and Western blotting, and the results indicated that VAChT mutant mice have profound cardiac remodeling and reactivation of the fetal gene program. This phenotype was attributable to reduced cholinergic tone, since administration of the cholinesterase inhibitor pyridostigmine for 2 weeks reversed the cardiac phenotype in mutant mice. Our findings provide direct evidence that decreased cholinergic neurotransmission and underlying autonomic imbalance cause plastic alterations that contribute to heart dysfunction. PMID:20123977

Lara, Aline; Damasceno, Denis D.; Pires, Rita; Gros, Robert; Gomes, Enéas R.; Gavioli, Mariana; Lima, Ricardo F.; Guimarães, Diogo; Lima, Patricia; Bueno, Carlos Roberto; Vasconcelos, Anilton; Roman-Campos, Danilo; Menezes, Cristiane A. S.; Sirvente, Raquel A.; Salemi, Vera M.; Mady, Charles; Caron, Marc G.; Ferreira, Anderson J.; Brum, Patricia C.; Resende, Rodrigo R.; Cruz, Jader S.; Gomez, Marcus Vinicius; Prado, Vania F.; de Almeida, Alvair P.; Prado, Marco A. M.; Guatimosim, Silvia

2010-01-01

251

Spontaneous recovery of cochlear fibrocytes after severe degeneration caused by acute energy failure  

PubMed Central

Cochlear fibrocytes in the lateral wall region play a critical role in the regulation of inner ear ion and fluid homeostasis, although these are non-sensory cells. Along with other non-sensory cells, fibrocytes in the spiral ligament have been reported to repopulate themselves after damage. However, the studies of regeneration of cochlear fibrocytes have been difficult because a suitable fibrocyte-specific degeneration model did not exist. Therefore, we analyzed cochlear fibrocytes using a rat model of acute cochlear energy failure induced by a mitochondrial toxin. This model is unique because hearing loss is caused by apoptosis of fibrocytes in the cochlear lateral wall not by damage to sensory cells. Although this model involves severe damage to the cochlear lateral wall, delayed spontaneous regeneration occurs without any treatment. Moreover, partial hearing recovery is accompanied by morphological remodeling of the cochlear lateral wall. Two hypotheses are conceivable regarding this spontaneous recovery of cochlear fibrocytes. One is that residual cochlear fibrocytes proliferate spontaneously, followed by remodeling of the functional region of the lateral wall. Another is that some foreign cells such as bone marrow-derived cells promote morphological and functional recovery of the lateral wall. Acceleration of the lateral wall recovery promoted by these mechanisms may be a new therapeutic strategy against hearing loss. PMID:25206337

Mizutari, Kunio

2014-01-01

252

Reliability enhancement of APR + diverse protection system regarding common cause failures  

SciTech Connect

The Advanced Power Reactor Plus (APR +) nuclear power plant design has been developed on the basis of the APR1400 (Advanced Power Reactor 1400 MWe) to further enhance safety and economics. For the mitigation of Anticipated Transients Without Scram (ATWS) as well as Common Cause Failures (CCF) within the Plant Protection System (PPS) and the Emergency Safety Feature - Component Control System (ESF-CCS), several design improvement features have been implemented for the Diverse Protection System (DPS) of the APR + plant. As compared to the APR1400 DPS design, the APR + DPS has been designed to provide the Safety Injection Actuation Signal (SIAS) considering a large break LOCA accident concurrent with the CCF. Additionally several design improvement features, such as channel structure with redundant processing modules, and changes of system communication methods and auto-system test methods, are introduced to enhance the functional reliability of the DPS. Therefore, it is expected that the APR + DPS can provide an enhanced safety and reliability regarding possible CCF in the safety-grade I and C systems as well as the DPS itself. (authors)

Oh, Y. G.; Kim, Y. M.; Yim, H. S. [KEPCO Engineering and Construction Company, Inc., 1045 Daedeok-Daero, Yuseong-gu, Daejeon 305-353 (Korea, Republic of); Lee, S. J. [Chungnam National Univ., 99 Daehak-ro, Yuseong-gu, Daejeon 305-764 (Korea, Republic of)

2012-07-01

253

Primary Respiratory Chain Disease Causes Tissue-Specific Dysregulation of the Global Transcriptome and Nutrient-Sensing Signaling Network  

PubMed Central

Primary mitochondrial respiratory chain (RC) diseases are heterogeneous in etiology and manifestations but collectively impair cellular energy metabolism. Mechanism(s) by which RC dysfunction causes global cellular sequelae are poorly understood. To identify a common cellular response to RC disease, integrated gene, pathway, and systems biology analyses were performed in human primary RC disease skeletal muscle and fibroblast transcriptomes. Significant changes were evident in muscle across diverse RC complex and genetic etiologies that were consistent with prior reports in other primary RC disease models and involved dysregulation of genes involved in RNA processing, protein translation, transport, and degradation, and muscle structure. Global transcriptional and post-transcriptional dysregulation was also found to occur in a highly tissue-specific fashion. In particular, RC disease muscle had decreased transcription of cytosolic ribosomal proteins suggestive of reduced anabolic processes, increased transcription of mitochondrial ribosomal proteins, shorter 5?-UTRs that likely improve translational efficiency, and stabilization of 3?-UTRs containing AU-rich elements. RC disease fibroblasts showed a strikingly similar pattern of global transcriptome dysregulation in a reverse direction. In parallel with these transcriptional effects, RC disease dysregulated the integrated nutrient-sensing signaling network involving FOXO, PPAR, sirtuins, AMPK, and mTORC1, which collectively sense nutrient availability and regulate cellular growth. Altered activities of central nodes in the nutrient-sensing signaling network were validated by phosphokinase immunoblot analysis in RC inhibited cells. Remarkably, treating RC mutant fibroblasts with nicotinic acid to enhance sirtuin and PPAR activity also normalized mTORC1 and AMPK signaling, restored NADH/NAD+ redox balance, and improved cellular respiratory capacity. These data specifically highlight a common pathogenesis extending across different molecular and biochemical etiologies of individual RC disorders that involves global transcriptome modifications. We further identify the integrated nutrient-sensing signaling network as a common cellular response that mediates, and may be amenable to targeted therapies for, tissue-specific sequelae of primary mitochondrial RC disease. PMID:23894440

Zhang, Zhe; Tsukikawa, Mai; Peng, Min; Polyak, Erzsebet; Nakamaru-Ogiso, Eiko; Ostrovsky, Julian; McCormack, Shana; Place, Emily; Clarke, Colleen; Reiner, Gail; McCormick, Elizabeth; Rappaport, Eric; Haas, Richard; Baur, Joseph A.; Falk, Marni J.

2013-01-01

254

Investigation into the causes of canine infectious respiratory disease: antibody responses to canine respiratory coronavirus and canine herpesvirus in two kennelled dog populations  

Microsoft Academic Search

Summary. Two training centres for working dogs were monitored for one year to determine the presence of viruses and viral antibodies and their association with canine infectious respiratory disease (CIRD). Tonsillar swabs and serum were obtained from dogs on entry into the kennels and in regular intervals thereafter. Additional samples were collected during outbreaks of CIRD. The swabs were examined

K. Erles; J. Brownlie

2005-01-01

255

Digoxin Reduces 30-Day All-Cause Hospital Admission in Older Patients with Chronic Systolic Heart Failure  

PubMed Central

BACKGROUND Heart failure is a leading cause of hospital admission and readmission in older adults. The new United States healthcare reform law has created provisions for financial penalties for hospitals with higher-than-expected 30-day all-cause readmission rates for hospitalized Medicare beneficiaries ?65 years with heart failure. We examined the effect of digoxin on 30-day all-cause hospital admission in older patients with heart failure and reduced ejection fraction. METHODS In the main Digitalis Investigation Group (DIG) trial, 6800 ambulatory patients with chronic heart failure (ejection fraction ?45%) were randomly assigned to digoxin or placebo. Of these, 3405 were ?65 years (mean age, 72 years, 25% women, 11% non-whites). The main outcome in the current analysis was 30-day all-cause hospital admission. RESULTS In the first 30 days after randomization, all-cause hospitalization occurred in 5.4% (92/1693) and 8.1% (139/1712) of patients in the digoxin and placebo groups, respectively, (hazard ratio {HR} when digoxin was compared with placebo, 0.66; 95% confidence interval {CI}, 0.51–0.86; p=0.002). Digoxin also reduced both 30-day cardiovascular (3.5% vs. 6.5%; HR, 0.53; 95% CI, 0.38–0.72; p<0.001) and heart failure (1.7 vs. 4.2%; HR, 0.40; 95% CI, 0.26–0.62; p<0.001) hospitalizations, with similar trends for 30-day all-cause mortality (0.7% vs. 1.3%; HR, 0.55; 95% CI, 0.27–1.11; p=0.096). Younger patients were at lower risk of events but obtained similar benefits from digoxin. CONCLUSIONS Digoxin reduces 30-day all-cause hospital admission in ambulatory older patients with chronic systolic heart failure. Future studies need to examine its effect on 30-day all-cause hospital readmission in hospitalized patients with acute heart failure. PMID:23490060

Bourge, Robert C.; Fleg, Jerome L.; Fonarow, Gregg C.; Cleland, John G.F.; McMurray, John J.V.; van Veldhuisen, Dirk J.; Gheorghiade, Mihai; Patel, Kanan; Aban, Inmaculada B.; Allman, Richard M.; White-Williams, Connie; White, Michel; Filippatos, Gerasimos S.; Anker, Stefan D.; Ahmed, Ali

2013-01-01

256

A Multiple Indicators Multiple Cause (MIMIC) model of respiratory health and household factors in Chinese children: the seven Northeastern cities (SNEC) study.  

PubMed

In China, with the rapid economic development and improvement of living standards over the past few decades, the household living environment has shifted dramatically. The aim of the present study is to assess the impact of home environment factors on respiratory symptoms and asthma in Chinese children. Investigators analyzed data collected in the 25 districts from the seven Northeastern cities to examine health effects on respiratory symptoms and asthma in 31,049 children aged 2-14 years. Factor analysis was used to reduce 33 children's lifestyle and household variables to six new 'factor' variables. The multiple indicators multiple causes approach was used to examine the relationship between indoor air pollution and respiratory health status, controlling for covariates. Factor analyses generated six factor variables of potential household risk factors from an original list of 33 variables. The respiratory symptoms and asthma were significantly associated with the recent home renovation factor (estimate = 0.076, p < 0.001), pet ownership factor (estimate = 0.095, p < 0.001), environmental tobacco smoke (ETS) exposure factor (estimate = 0.181, p < 0.001) and PVC-flooring factor (estimate = 0.031, p = 0.007). Home ventilation factor was not related to any respiratory condition (estimate = 0.028, p = 0.074). Independent respiratory health effects existed for multiple household environmental factors recent home renovation, pet ownership, ETS, and PVC-flooring. PMID:23440490

Dong, Guang-Hui; Qian, Zhengmin; Fu, Qiang; Wang, Jing; Trevathan, Edwin; Ma, Wenjun; Liu, Miao-Miao; Wang, Da; Ren, Wan-Hui; Ong, Kee-Hean; Ferguson, Tekeda Freeman; Riley, Erin; Simckes, Maayan

2014-01-01

257

Abstract--The parametric shifts or circuit failures caused by transistor aging have become more severe with shrinking device  

E-print Network

much of the performance benefit gained by traditional device scaling. In particular, the parametricAbstract-- The parametric shifts or circuit failures caused by transistor aging have become more. Finally, technology scaling has led to a massive increase in the number of operating conditions devices

Kim, Chris H.

258

Competitive Intelligence analysis failure: diagnosing individual level causes and implementing organisational level remedies  

Microsoft Academic Search

It is anticipated that any Competitive Intelligence (CI) professional would want to perform the analysis task and execute their responsibilities successfully over time. Such competencies would normally come with added experience on the job, as should the ability to reduce the risk of failure by diagnosing potential pitfalls. This paper presents: (a) a unique four-level hierarchical model of analysis failure;

Craig S. Fleisher; Sheila Wright

2010-01-01

259

Determining the Cause of a Header Failure in a Natural Gas Production Facility  

SciTech Connect

An investigation was made into the premature failure of a gas-header at the Rocky Mountain Oilfield Testing Center (RMOTC) natural gas production facility. A wide variety of possible failure mechanisms were considered: design of the header, deviation from normal pipe alloy composition, physical orientation of the header, gas composition and flow rate, type of corrosion, protectiveness of the interior oxide film, time of wetness, and erosion-corrosion. The failed header was examined using metallographic techniques, scanning electron microscopy, and microanalysis. A comparison of the failure site and an analogous site that had not failed, but exhibited similar metal thinning was also performed. From these studies it was concluded that failure resulted from erosion-corrosion, and that design elements of the header and orientation with respect to gas flow contributed to the mass loss at the failure point.

Matthes, S.A.; Covino, B.S., Jr.; Bullard, S.J.; Ziomek-Moroz, M.; Holcomb, G.R.

2007-03-01

260

The heritability of cause-specic mortality: a correlated gamma-frailty model applied to mortality due to respiratory diseases in Danish twins born 1870-1930  

Microsoft Academic Search

SUMMARY The genetic inuence on susceptibility to diseases of the respiratory system and all-cause mortality was studied using data for identical (MZ) and fraternal (DZ) twins. Data from the Danish Twin Register include 1344 MZ and 2411 DZ male twin pairs and 1470 MZ and 2730 DZ female twin pairs born between 1870 and 1930, where both individuals were alive

Andreas Wienke; Niels V. Holm; Kaare Christensen; Axel Skytthe; James W. Vaupel; Anatoli I. Yashin

261

Effect of noninvasive mechanical ventilation in elderly patients with hypercapnic acute-on-chronic respiratory failure and a do-not-intubate order  

PubMed Central

Noninvasive mechanical ventilation (NIMV) is effective in the treatment of patients with acute respiratory failure (ARF). It proved to reduce the need of endotracheal intubation (ETI), the incidence of ETI-associated pneumonia, and mortality compared to nonventilated patients. A particular aspect concerns the outcome of NIMV in patients referring to an emergency room (ER) for ARF, and with a do-not-intubate (DNI) status due to advanced age or critical conditions. The aim of our study is to assess the outcome of NIMV in a group of elderly patients with acute hypercapnic ARF who had a DNI status. An overall number of 62 subjects (30 males, 32 females, mean age 81 ± 4.8 years, range 79–91 years) referred to our semi-intensive respiratory department were enrolled in the study. The underlying diseases were severe chronic obstructive pulmonary disease (COPD) in 50/62 subjects, restrictive thoracic disorders in 7/62 subjects, and multiorgan failure in 5/62 subjects. Fifty-four/62 patients were successfully treated with NIMV while 2/62 did not respond to NIMV and were therefore submitted to ETI (one survived). Among NIMV-treated patients, death occurred in 6 patients after a mean of 9.9 days; the overall rate of NIMV failure was 12.9%. Negative prognostic factors for NIMV response proved to be: an older age, a low Glasgow Coma Score, a high APACHE score at admission, a high PaCO2 after 12 hours and a low pH both after 1 and 12 hours of NIMV. We conclude that elderly patients with acute hypercapnic ARF with a DNI status can be successfully treated by NIMV. PMID:19281095

Scarpazza, Paolo; Incorvaia, Cristoforo; di Franco, Giuseppe; Raschi, Stefania; Usai, Pierfranco; Bernareggi, Monica; Bonacina, Cristiano; Melacini, Chiara; Vanni, Silvia; Bencini, Serena; Pravettoni, Chiara; Di Cara, Giuseppe; Yacoub, Mona-Rita; Galeazzo, Gian; Riario-Sforza; Guffanti, Enrico; Casali, Walter

2008-01-01

262

Short-term reversibility of ultrastructural changes in pulmonary capillaries caused by stress failure  

NASA Technical Reports Server (NTRS)

We previously showed that when the pulmonary capillaries in anesthetized rabbits are exposed to a transmural pressure (Ptm) of approximately 40 mmHg, stress failure of the walls occurs with disruption of the capillary endothelium, alveolar epithelium, or sometimes all layers. The present study was designed to determine whether some of the ultrastructural changes are rapidly reversible when the capillary pressure is reduced. To test this, the Ptm was raised to 52.5 cmH2O for 1 min of blood perfusion and then reduced to 12.5 cmH2O for 3 min of saline-dextran perfusion, followed by intravascular fixation at the same pressure. In another group of animals, the pressure was elevated for 1 min of blood and 3 min of saline-dextran before being reduced. The results were compared with previous studies in which the capillary pressures were maintained elevated at 52.5 cmH2O during the entire procedure. Control studies were also done at sustained low pressures. The results showed that the number of endothelial and epithelial breaks per millimeter and the total fraction area of the breaks were reduced when the pressure was lowered. For example, the number of endothelial breaks per millimeter decreased from 7.1 +/- 2.1 to 2.4 +/- 0.7, and the number of epithelial breaks per millimeter fell from 11.4 +/- 3.7 to 3.4 +/- 0.7. There was evidence that the breaks that closed were those that were initially small and were associated with an intact basement membrane. The results suggest that cells can move along their underlying matrix by rapid disengagement and reattachment of cell adhesion molecules, causing breaks to open or close within minutes.(ABSTRACT TRUNCATED AT 250 WORDS).

Elliott, A. R.; Fu, Z.; Tsukimoto, K.; Prediletto, R.; Mathieu-Costello, O.; West, J. B.

1992-01-01

263

Long-Term Exposure to Environmental Concentrations of the Pharmaceutical Ethynylestradiol Causes Reproductive Failure in Fish  

PubMed Central

Heightened concern over endocrine-disrupting chemicals is driven by the hypothesis that they could reduce reproductive success and affect wildlife populations, but there is little evidence for this expectation. The pharmaceutical ethynylestradiol (EE2) is a potent endocrine modulator and is present in the aquatic environment at biologically active concentrations. To investigate impacts on reproductive success and mechanisms of disruption, we exposed breeding populations (n = 12) of zebrafish (Danio rerio) over multiple generations to environmentally relevant concentrations of EE2. Life-long exposure to 5 ng/L EE2 in the F1 generation caused a 56% reduction in fecundity and complete population failure with no fertilization. Conversely, the same level of exposure for up to 40 days in mature adults in the parental F0 generation had no impact on reproductive success. Infertility in the F1 generation after life-long exposure to 5 ng/L EE2 was due to disturbed sexual differentiation, with males having no functional testes and either undifferentiated or inter-sex gonads. These F1 males also showed a reduced vitellogenic response when compared with F0 males, indicating an acclimation to EE2 exposure. Depuration studies found only a partial recovery in reproductive capacity after 5 months. Significantly, even though the F1 males lacked functional testes, they showed male-pattern reproductive behavior, inducing the spawning act and competing with healthy males to disrupt fertilization. Endocrine disruption is therefore likely to affect breeding dynamics and reproductive success in group-spawning fish. Our findings raise major concerns about the population-level impacts for wildlife of long-term exposure to low concentrations of estrogenic endocrine disruptors. PMID:15579420

Nash, Jon P.; Kime, David E.; Van der Ven, Leo T. M.; Wester, Piet W.; Brion, François; Maack, Gerd; Stahlschmidt-Allner, Petra; Tyler, Charles R.

2004-01-01

264

Digoxin Use and Lower 30-Day All-Cause Readmission for Medicare Beneficiaries Hospitalized for Heart Failure  

PubMed Central

BACKGROUND Heart failure is the leading cause for hospital readmission, the reduction of which is a priority under the Affordable Care Act. Digoxin reduces 30-day all-cause hospital admission in chronic systolic heart failure. Whether digoxin is effective in reducing readmission after hospitalization for acute decompensation remains unknown. METHODS Of the 5153 Medicare beneficiaries hospitalized for acute heart failure and not receiving digoxin, 1054 (20%) received new discharge prescriptions for digoxin. Propensity scores for digoxin use, estimated for each of the 5153 patients, were used to assemble a matched cohort of 1842 (921 pairs) patients (mean age, 76 years; 56% women; 25% African American) receiving and not receiving digoxin, who were balanced on 55 baseline characteristics. RESULTS 30-day all-cause readmission occurred in 17% and 22% of matched patients receiving and not receiving digoxin, respectively (hazard ratio {HR} for digoxin, 0.77; 95% confidence interval {CI}, 0.63–0.95). This beneficial association was observed only in those with ejection fraction <45% (HR, 0.63; 95% CI, 0.47–0.83), but not in those with ejection fraction ?45% (HR, 0.91; 95% CI, 0.60–1.37; p for interaction, 0.145), a difference that persisted throughout first 12-month post-discharge (p for interaction, 0.019). HRs (95% CIs) for 12-month heart failure readmission and all-cause mortality were 0.72 (0.61–0.86) and 0.83 (0.70–0.98), respectively. CONCLUSIONS In Medicare beneficiaries with systolic heart failure, a discharge prescription of digoxin was associated with lower 30-day all-cause hospital readmission, which was maintained at 12 months, and was not at the expense of higher mortality. Future randomized controlled trials are needed to confirm these findings. PMID:24257326

Ahmed, Ali; Bourge, Robert C.; Fonarow, Gregg C.; Patel, Kanan; Morgan, Charity J.; Fleg, Jerome L.; Aban, Inmaculada B.; Love, Thomas E.; Yancy, Clyde W.; Deedwania, Prakash; van Veldhuisen, Dirk J.; Filippatos, Gerasimos S.; Anker, Stefan D.; Allman, Richard M.

2013-01-01

265

Signal failure of type 2 comprehensive unattended sleep studies in patients with suspected respiratory sleep disordered breathing.  

PubMed

We designed this study to assess the signal failure and sensor loss of unattended type 2 comprehensive polysomnography (PSG) and compared that with in-lab attended PSG. Type 2 PSG was performed for 41 patients. The signal failure was estimated and compared to the signal failure in 60 patients for the in-lab PSGs. The signal failure in each individual electroencephalographic (EEG) channel, complete EEG signals, electro-oculography (EOG), naso-oral flow, and thoracic belt were significantly greater in the unattended sleep studies. The failure rate for the different signals ranged from 0.128 min in electrocardiography (EKG) to 67.36 min in the thoracic belt signal. However, that did not affect the success rate of the studies. Acceptable scorable data was available in 97% of the performed unattended PSGs. Unattended type 2 sleep studies can be performed for clinical use in the evaluation of sleep disordered breathing with low signal failure and sensor loss if the proper hook-up procedure was followed. PMID:15785915

BaHammam, Ahmed S

2005-03-01

266

Investigation into the cause of pneumatic actuator failure on the HypoSurface  

E-print Network

An investigation into the failure of pneumatic actuators on the HypoSurface was conducted to provide information on the current HypoSurface prototype. Using a systematic approach throughout testing, piston components were ...

Chun, Darren M. K. (Darren Masayasu Kekoa)

2007-01-01

267

The Mechanisms and Countermeasures of Failure in Low-Voltage Electronic Watt-Hour-Meters Caused by Lightning  

NASA Astrophysics Data System (ADS)

Experimental study was carried out for classified a mechanism of failure of low-voltage electronic Watt-Hour Meters. As the results, the mechanism of failure of electronic meters is clarified into two patterns. One is due to the magnetic field generated by lightning current passing through the inside of an electronic meter. The other is due to the blow out of electric wire caused by lightning current flowing into the power supply circuit for processing unit. For these failure mechanisms, following counter measures were clarified. One is that a magnetic shielding measure using a metallic plate covering the processing unit was effective for reducing the magnetic field. The other measure is that a relocation of the ZnO device in the electronic meter was effective for reducing the lightning current flowing into the power supply circuit.

Asakawa, Akira; Hurukawa, Seiji; Takahashi, Akihisa; Ishimoto, Kazuyuki

268

The acute respiratory distress syndrome  

PubMed Central

The acute respiratory distress syndrome (ARDS) is an important cause of acute respiratory failure that is often associated with multiple organ failure. Several clinical disorders can precipitate ARDS, including pneumonia, sepsis, aspiration of gastric contents, and major trauma. Physiologically, ARDS is characterized by increased permeability pulmonary edema, severe arterial hypoxemia, and impaired carbon dioxide excretion. Based on both experimental and clinical studies, progress has been made in understanding the mechanisms responsible for the pathogenesis and the resolution of lung injury, including the contribution of environmental and genetic factors. Improved survival has been achieved with the use of lung-protective ventilation. Future progress will depend on developing novel therapeutics that can facilitate and enhance lung repair. PMID:22850883

Matthay, Michael A.; Ware, Lorraine B.; Zimmerman, Guy A.

2012-01-01

269

Middle East Respiratory Syndrome (MERS)  

MedlinePLUS

Middle East Respiratory Syndrome Coronavirus; MERS-CoV; Novel coronavirus; nCoV ... Middle East Respiratory Syndrome (MERS) is a severe respiratory illness. It causes fever, coughing, and shortness of breath. About 30% of ...

270

Outcomes of a Telehealth Intervention for Homebound Older Adults with Heart or Chronic Respiratory Failure: A Randomized Controlled Trial  

ERIC Educational Resources Information Center

Purpose: Telehealth care is emerging as a viable intervention model to treat complex chronic conditions, such as heart failure (HF) and chronic obstructive pulmonary disease (COPD), and to engage older adults in self-care disease management. Design and Methods: We report on a randomized controlled trial examining the impact of a multifaceted…

Gellis, Zvi D.; Kenaley, Bonnie; McGinty, Jean; Bardelli, Ellen; Davitt, Joan; Ten Have, Thomas

2012-01-01

271

Electrocardiographic Predictors of Incident Congestive Heart Failure and All-Cause Mortality in Postmenopausal Women The Women's Health Initiative  

Microsoft Academic Search

Background—Information is limited about ECG predictors of the risk of incident congestive heart failure (CHF), particularly in women without overt manifestations of cardiovascular disease (CVD). Methods and Results—We evaluated hazard ratios for incident CHF and all-cause mortality using Cox regression in 38 283 participants of the Women's Health Initiative (WHI) during a 9-year follow-up. All risk models were adjusted for

Pentti M. Rautaharju; Charles Kooperberg; Joseph C. Larson; Andrea LaCroix

2010-01-01

272

Congenital coronary artery fistulae: a rare cause of heart failure in adults  

PubMed Central

Coronary artery fistulae are uncommon, reported in 0.25% of patients undergoing coronary angiography. Two patients with congenital coronary artery fistula and coronary artery disease who presented with symptoms of exacerbated congestive heart failure out of proportion to their atherosclerotic burden were successfully treated by epicardial fistula ligation and coronary artery bypass grafting with marked improvement in functional status. PMID:24886594

2014-01-01

273

Methods of data collection and analysis for the economic evaluation alongside a national, multi-centre trial in the UK: Conventional ventilation or ECMO for Severe Adult Respiratory Failure (CESAR)  

Microsoft Academic Search

BACKGROUND: Extracorporeal Membrane Oxygenation (ECMO) is a technology used in treatment of patients with severe but potentially reversible respiratory failure. A multi-centre randomised controlled trial (CESAR) was funded in the UK to compare care including ECMO with conventional intensive care management. The protocol and funding for the CESAR trial included plans for economic data collection and analysis. Given the high

Mariamma M Thalanany; Miranda Mugford; Clare Hibbert; Nicola J Cooper; Ann Truesdale; Steven Robertson; Ravindranath Tiruvoipati; Diana R Elbourne; Giles J Peek; Felicity Clemens; Polly Hardy; Andrew Wilson

2008-01-01

274

Respiratory difficulties and breathing disorders in achondroplasia.  

PubMed

Respiratory difficulties and breathing disorders in achondroplasia are thought to underlie the increased risk for sudden infant death and neuropsychological deficits seen in this condition. This review evaluates literature regarding respiratory dysfunctions and their sequelae in patients with achondroplasia. The limited number of prospective studies of respiratory disease in achondroplasia means that observational studies and case series provide a large proportion of the data regarding the spectrum of respiratory diseases in achondroplasia and their treatments. Amongst clinical respiratory problems described, snoring is the commonest observed abnormality, but the reported incidence of obstructive sleep apnoea (OSA) shows wide variance (10% to 75%). Reported treatments of OSA include adenotonsillectomy, the use of CPAP, and surgical improvement of the airway, including mid-face advancement. Otolaryngologic manifestations are also common. Respiratory failure due to small thoracic volumes is reported, but uncommon. Mortality rate at all ages was 2.27 (CI: 1.7-3.0) with age-specific mortality increased at all ages. Sudden death was most common in infants and children. Cardiovascular events are the main cause of mortality in adults. Despite earlier recognition and treatment of respiratory complications of achondroplasia, increased mortality rates and other complications remain high. Future and ongoing evaluation of the prevalence and impact of respiratory disorders, particularly OSA, in achondroplasia is recommended. PMID:23523391

Afsharpaiman, S; Saburi, A; Waters, Karen A

2013-12-01

275

20 CFR 404.454 - Good cause for failure to make required reports.  

Code of Federal Regulations, 2012 CFR

...limitations (including any lack of facility with the English language) the individual may have. For example, good cause...report, good cause normally will not be found for the second or subsequent violation. [38 FR 3597, Feb....

2012-04-01

276

20 CFR 404.454 - Good cause for failure to make required reports.  

Code of Federal Regulations, 2010 CFR

...limitations (including any lack of facility with the English language) the individual may have. For example, good cause...report, good cause normally will not be found for the second or subsequent violation. [38 FR 3597, Feb....

2010-04-01

277

20 CFR 404.454 - Good cause for failure to make required reports.  

Code of Federal Regulations, 2011 CFR

...limitations (including any lack of facility with the English language) the individual may have. For example, good cause...report, good cause normally will not be found for the second or subsequent violation. [38 FR 3597, Feb....

2011-04-01

278

20 CFR 404.454 - Good cause for failure to make required reports.  

Code of Federal Regulations, 2013 CFR

...limitations (including any lack of facility with the English language) the individual may have. For example, good cause...report, good cause normally will not be found for the second or subsequent violation. [38 FR 3597, Feb....

2013-04-01

279

20 CFR 404.454 - Good cause for failure to make required reports.  

Code of Federal Regulations, 2014 CFR

...limitations (including any lack of facility with the English language) the individual may have. For example, good cause...report, good cause normally will not be found for the second or subsequent violation. [38 FR 3597, Feb....

2014-04-01

280

New perspectives in Respiratory Syncitial Virus infection.  

PubMed

Respiratory syncitial virus (RSV) is the most common cause of lower respiratory tract infections (LRTI) in children worldwide and it is associated with significant childhood morbidity. Acute infection may result in respiratory failure with varying degrees of severity, and increasing evidence supports a role of RSV infection as a key determinant for the development of subsequent chronic respiratory disease. Independent predictors of RSV severity include; prematurity, congenital heart disease, cystic fibrosis, immune defects and neuromuscular disorders. Passive immunization with palivizumab has proven to be safe and effective for preventing RSV hospitalization in infants at higher risk of acquiring severe RSV infection, but its expense and cumbersome monthly intravenous delivery schedule make it inaccessible to many. Furthermore, implementing prophylaxis in 32- to 35-week-gestational age infants and the mode of its administration still represent areas of uncertainty. In this review, we describe several aspects of RSV infection and analyze recent advances in the assessment of cost-effective palivizumab prophylaxis. PMID:24059554

Del Vecchio, Antonio; Ferrara, Teresa; Maglione, Marco; Capasso, Letizia; Raimondi, Francesco

2013-10-01

281

Causes of recruitment failure in freshwater mussel populations in southeastern New York.  

PubMed

Populations of freshwater mussels (Unionoida) are declining or disappearing from many waters around the world. In many declining populations, recruitment fails before adult mortality occurs, resulting in relict populations that can persist for decades. We tested whether recruitment failure in populations of the freshwater mussel Elliptio complanata was associated with invasion of nonnative crayfish, loss of a primary fish host (American eel Anguilla rostrata), excessive inputs of fine sediments, or unfavorable interstitial water chemistry (too little dissolved oxygen or too much un-ionized ammonia). We sampled mussel populations, crayfish populations, and environmental conditions at 14 sites on wadeable streams in southeastern New York. Five of the mussel populations had little or no recent recruitment. We found no association between recruitment failure and crayfish, American eels, fine sediments, or interstitial dissolved oxygen. In contrast, recruitment failure was strongly associated with high concentrations (>0.2 microg N/L) of un-ionized ammonia. This threshold is much lower than thresholds for acute ammonia toxicity identified in laboratory studies. We suggest that excessive concentrations of interstitial un-ionized ammonia may be responsible for widespread declines of freshwater mussel populations, especially in agricultural areas. PMID:23092015

Strayer, David L; Malcom, Heather M

2012-09-01

282

Methods for predicting peak discharge of floods caused by failure of natural and constructed earthen dams  

USGS Publications Warehouse

Floods from failures of natural and constructed dams constitute a widespread hazard to people and property. Expeditious means of assessing flood hazards are necessary, particularly in the case of natural dams, which may form suddenly and unexpectedly. We revise statistical relations (derived from data for past constructed and natural dam failures) between peak discharge (Q(p)) and water volume released (V(0)) or drop in lake level (d) but assert that such relations, even when cast into a dimensionless form, are of limited utility because they fail to portray the effect of breach-formation rate. We then analyze a simple, physically based model of dam-breach formation to show that the hydrograph at the breach depends primarily on a dimensionless parameter ?? = kV0/g1/2d7/2, where k is the mean erosion rate of the breach and g is acceleration due to gravity. The functional relationship between Q(p) and ?? takes asymptotically distinct forms depending on whether ?? > 1 (relatively fast breach formation or large lake volume). Theoretical predictions agree well with data from dam failures for which k, and thus ??, can be estimated. The theory thus provides a rapid means of predicting the plausible range of values of peak discharge at the breach in an earthen dam as long as the impounded water volume and the water depth at the dam face can be estimated.

Walder, J.S.; O'Connor, J. E.

1997-01-01

283

Compounds from multilayer plastic bags cause reproductive failures in artificial insemination  

PubMed Central

High levels of reproductive failure were detected in some Spanish sow farms in the Spring of 2010. Regular returns to estrus and variable reductions in litter size were observed. The problem started suddenly and did not appear to be related to the quality of the ejaculates, disease, alterations of body condition or any other apparent reasons. Subsequent studies determined that the problem was the origin of the plastic bags used for semen storage. Chemical analysis of the suspicious bags identified unexpected compounds such as BADGE, a cyclic lactone and an unknown phthalate that leached into the semen at concentrations of 0.2 to 2.5?mg/L. Spermatozoa preserved in these bags passed all of the routine quality control tests, and no differences were observed between storage in the control and suspicious bags (p > 0.05). In vitro fecundation tests and endocrine profiler panel analysis (EPP) did not show any alterations, whereas the in vivo tests confirmed the described failure. This is the first described relationship between reproductive failure and toxic compounds released from plastic bags. PMID:24810330

Nerin, C.; Ubeda, J. L.; Alfaro, P.; Dahmani, Y.; Aznar, M.; Canellas, E.; Ausejo, R.

2014-01-01

284

Compounds from multilayer plastic bags cause reproductive failures in artificial insemination  

NASA Astrophysics Data System (ADS)

High levels of reproductive failure were detected in some Spanish sow farms in the Spring of 2010. Regular returns to estrus and variable reductions in litter size were observed. The problem started suddenly and did not appear to be related to the quality of the ejaculates, disease, alterations of body condition or any other apparent reasons. Subsequent studies determined that the problem was the origin of the plastic bags used for semen storage. Chemical analysis of the suspicious bags identified unexpected compounds such as BADGE, a cyclic lactone and an unknown phthalate that leached into the semen at concentrations of 0.2 to 2.5 mg/L. Spermatozoa preserved in these bags passed all of the routine quality control tests, and no differences were observed between storage in the control and suspicious bags (p > 0.05). In vitro fecundation tests and endocrine profiler panel analysis (EPP) did not show any alterations, whereas the in vivo tests confirmed the described failure. This is the first described relationship between reproductive failure and toxic compounds released from plastic bags.

Nerin, C.; Ubeda, J. L.; Alfaro, P.; Dahmani, Y.; Aznar, M.; Canellas, E.; Ausejo, R.

2014-05-01

285

Molecular epidemiological analysis of Pseudomonas aeruginosa strains causing failure of antibiotic therapy in cystic fibrosis patients.  

PubMed

A combination of esterase electrophoretic typing and analysis of the restriction fragment length polymorphism of ribosomal DNA regions (ribotyping) was used to compare 27 Pseudomonas aeruginosa strains isolated before and after two-week courses of anti-pseudomonal treatment in seven cystic fibrosis patients. A total of 12 courses of therapy were studied in which ciprofloxacin, ceftazidime, azlocillin or imipenem were used alone or in combination with tobramycin. Isolates at a count of greater than or equal to 10(6) cfu/ml of sputum were collected when there was evidence of therapeutic failure on the basis of persistence of isolates whether or not they were resistant to the antibiotic used for therapy. Emergence of resistance was observed in ten cases and failure to eradicate sensitive strains in five cases. Among the 27 isolates, eight zymotypes and five ribotypes were identified. With this typing approach, resistant post-therapy isolates were found to be identical to pre-therapy isolates in all cases but one. However, in one case an additional resistant strain was isolated after therapy besides that initially present. In all five cases in which susceptibility was still observed after treatment, pre-therapy and post-therapy isolates were indistinguishable. Using this molecular typing approach, all the strains were typable. Thus combination of esterase typing and ribotyping should improve the analysis of therapeutic failure in cystic fibrosis patients. PMID:1358612

Bingen, E; Denamur, E; Picard, B; Goullet, P; Lambert-Zechovsky, N; Foucaud, P; Navarro, J; Elion, J

1992-05-01

286

Traumatic Tension Pneumothorax as a Cause of ICD Failure: A Case Report and Review of the Literature  

PubMed Central

Background. Tension pneumothorax can infrequently cause ventricular arrhythmias and increase the threshold of defibrillation. It should be suspected whenever there is difficulty in defibrillation for a ventricular arrhythmia. Purpose. To report a case of traumatic tension pneumothorax leading to ventricular tachycardia and causing defibrillator failure. Case. A 65-year-old African-American female was brought in to our emergency department complaining of dyspnea after being forced down by cops. She had history of mitral valve replacement for severe mitral regurgitation and biventricular implantable cardioverter defibrillator inserted for nonischemic cardiomyopathy. Shortly after arrival, she developed sustained ventricular tachycardia, causing repetitive unsuccessful ICD shocks. She was intubated and ventricular tachycardia resolved with amiodarone. Chest radiograph revealed large left sided tension pneumothorax which was promptly drained. The patient was treated for congestive heart failure; she was extubated on the third day of admission, and the chest tube was removed. Conclusion. Prompt recognition of tension pneumothorax is essential, by maintaining a high index of suspicion in patients with an increased defibrillation threshold causing ineffective defibrillations. PMID:25400953

2014-01-01

287

Plasma metabonomics study on Chinese medicine syndrome evolution of heart failure rats caused by LAD ligation  

PubMed Central

Background Chinese medicine syndromes (Zheng) in many disease models are not clearly characterized or validated, and the concepts of Chinese medicine syndromes are confounding and controversial. Metabonomics has been applied to the evaluation and classification of the Chinese medicine syndromes both in clinical and nonclinical studies. In this study, we aim to investigate the evolution of the Chinese medicine syndrome in myocardial infarction induced heart failure and to confirm the feasibility of the Zheng classification by plasma metabonomics in a syndrome and disease combination animal model. Methods The heart failure (HF) model was induced by ligation of the left anterior descending coronary artery (LAD) in Sprague–Dawley rats. The rats were divided into the following two groups: the HF model group (LAD ligation) and the sham operated group. GC-MS was used with pattern recognition technology and principal component analysis (PCA) to analyze the plasma samples at 4, 21 and 45 day after operation. Results It was determined that the period from 7 to 28 days was the stable time window of ischemic heart failure with qi deficiency and blood stasis syndrome (QDBS), and the qi deficiency syndrome occurred at 1 to 4 days and 45 to 60 days after operation. The results exhibited 5 plasma metabolite changes in the same trend at 4 and 21 day after the LAD operation, 7 at 21 and 45 day, and 2 at 4 and 45 day. No metabolite showed the same change at all of the 3 time points. At day 21 (the QDBS syndrome time point) after operation, 4 plasma metabolites showed the same trends with the results of our previous study on patients with the blood stasis syndrome. Conclusions The syndrome diagnosis is reliable in the HF rat model in this study. Plasma metabolites can provide a basis for the evaluation of Chinese medicine syndrome animal models. PMID:25012233

2014-01-01

288

Acute liver failure caused by severe acute hepatitis B: a case series from a multi-center investigation  

PubMed Central

Background Few data can be available regarding acute liver failure (ALF) caused by severe acute hepatitis B up to now. This study aims to report such cases from China. Findings We conducted a multi-center investigation on ALF from 7 tertiary hospitals in different areas of China. A total of 11 patients with ALF caused by severe acute hepatitis B were finally identified. In these patients, there were 10 male and 1 female patients. As a serious complication, apparent hemorrhage occurred in 9 patients. Eventually, in these 11 patients, 4 survived and 7 died. 4 died of heavy bleeding, 2 died of systemic inflammatory response syndrome and 1 died of irreversible coma. No patients received liver transplantation. Conclusions ALF caused by severe acute hepatitis B is worthy of formal studies based on its rarity and severity. PMID:24958233

2014-01-01

289

Bilateral ureteropelvic junction stenosis causing hydronephrosis and renal failure in an adult cat.  

PubMed

A 3.5-year-old male neutered cat was presented for investigation of renomegaly appreciated during a routine physical examination. Marked renomegaly due to bilateral hydronephrosis was detected and further testing identified International Renal Interest Society stage 2, non-hypertensive, non-proteinuric chronic kidney disease. Ten months later the cat was evaluated for acute lethargy; severe azotemia with oliguria was documented. Medical therapy failed to result in clinical improvement and the cat was euthanased. Necropsy revealed bilateral marked hydronephrosis secondary to a tortuous proximal ureter consistent with proximal ureteropelvic junction stenosis. This is the first report of this disorder leading to progressive renal failure in a cat. PMID:22914571

Foster, Jonathan D; Pinkerton, Marie E

2012-12-01

290

Failure of effervescent zinc acetate lozenges to alter the course of upper respiratory tract infections in Australian adults.  

PubMed Central

Effervescent lozenges containing 10 mg of zinc acetate were evaluated as a treatment of upper respiratory tract infections in a double-blind randomized trial by using a placebo which was indistinguishable to most observers in taste and appearance from the active material. Of the 70 treatment courses used by 55 individuals in 34 families, 63 (33 zinc and 30 placebo) were considered evaluable, in that the volunteer used the medication at least four times daily for at least 3 days, the average utilization being 5.4 days at an average dose of six lozenges daily. Six users of zinc reported nausea (versus no placebo users), and eight reported an unpleasant taste or aftertaste (versus one placebo user). No benefit was observed among the users of zinc acetate. The mean duration of symptoms in users of the zinc was 12.1 days, compared with 7.7 days in those who used the placebo. Nor was any beneficial effect of zinc evident among the four zinc-treated versus the two placebo-treated individuals from whom rhinovirus was grown. PMID:3307620

Douglas, R M; Miles, H B; Moore, B W; Ryan, P; Pinnock, C B

1987-01-01

291

MTO1 mutations are associated with hypertrophic cardiomyopathy and lactic acidosis and cause respiratory chain deficiency in humans and yeast.  

PubMed

We report three families presenting with hypertrophic cardiomyopathy, lactic acidosis, and multiple defects of mitochondrial respiratory chain (MRC) activities. By direct sequencing of the candidate gene MTO1, encoding the mitochondrial-tRNA modifier 1, or whole exome sequencing analysis, we identified novel missense mutations. All MTO1 mutations were predicted to be deleterious on MTO1 function. Their pathogenic role was experimentally validated in a recombinant yeast model, by assessing oxidative growth, respiratory activity, mitochondrial protein synthesis, and complex IV activity. In one case, we also demonstrated that expression of wt MTO1 could rescue the respiratory defect in mutant fibroblasts. The severity of the yeast respiratory phenotypes partly correlated with the different clinical presentations observed in MTO1 mutant patients, although the clinical outcome was highly variable in patients with the same mutation and seemed also to depend on timely start of pharmacological treatment, centered on the control of lactic acidosis by dichloroacetate. Our results indicate that MTO1 mutations are commonly associated with a presentation of hypertrophic cardiomyopathy, lactic acidosis, and MRC deficiency, and that ad hoc recombinant yeast models represent a useful system to test the pathogenic potential of uncommon variants, and provide insight into their effects on the expression of a biochemical phenotype. PMID:23929671

Baruffini, Enrico; Dallabona, Cristina; Invernizzi, Federica; Yarham, John W; Melchionda, Laura; Blakely, Emma L; Lamantea, Eleonora; Donnini, Claudia; Santra, Saikat; Vijayaraghavan, Suresh; Roper, Helen P; Burlina, Alberto; Kopajtich, Robert; Walther, Anett; Strom, Tim M; Haack, Tobias B; Prokisch, Holger; Taylor, Robert W; Ferrero, Ileana; Zeviani, Massimo; Ghezzi, Daniele

2013-11-01

292

Outbreak of acute respiratory disease caused by Mycoplasma pneumoniae on board a deployed U.S. navy ship.  

PubMed

We identified 179 cases of acute respiratory illness including 50 cases of radiographically confirmed pneumonia over the course of 4 months on a deployed U.S. Navy vessel. Laboratory tests showed Mycoplasma pneumoniae to be the etiological agent. This report represents the first published description of a shipboard outbreak of this pathogen. PMID:19846632

Sliman, Joseph A; Metzgar, David; Asseff, David C; Coon, Robert G; Faix, Dennis J; Lizewski, Stephen

2009-12-01

293

MTO1 Mutations are Associated with Hypertrophic Cardiomyopathy and Lactic Acidosis and Cause Respiratory Chain Deficiency in Humans and Yeast  

PubMed Central

We report three families presenting with hypertrophic cardiomyopathy, lactic acidosis, and multiple defects of mitochondrial respiratory chain (MRC) activities. By direct sequencing of the candidate gene MTO1, encoding the mitochondrial-tRNA modifier 1, or whole exome sequencing analysis, we identified novel missense mutations. All MTO1 mutations were predicted to be deleterious on MTO1 function. Their pathogenic role was experimentally validated in a recombinant yeast model, by assessing oxidative growth, respiratory activity, mitochondrial protein synthesis, and complex IV activity. In one case, we also demonstrated that expression of wt MTO1 could rescue the respiratory defect in mutant fibroblasts. The severity of the yeast respiratory phenotypes partly correlated with the different clinical presentations observed in MTO1 mutant patients, although the clinical outcome was highly variable in patients with the same mutation and seemed also to depend on timely start of pharmacological treatment, centered on the control of lactic acidosis by dichloroacetate. Our results indicate that MTO1 mutations are commonly associated with a presentation of hypertrophic cardiomyopathy, lactic acidosis, and MRC deficiency, and that ad hoc recombinant yeast models represent a useful system to test the pathogenic potential of uncommon variants, and provide insight into their effects on the expression of a biochemical phenotype. PMID:23929671

Baruffini, Enrico; Dallabona, Cristina; Invernizzi, Federica; Yarham, John W; Melchionda, Laura; Blakely, Emma L; Lamantea, Eleonora; Donnini, Claudia; Santra, Saikat; Vijayaraghavan, Suresh; Roper, Helen P; Burlina, Alberto; Kopajtich, Robert; Walther, Anett; Strom, Tim M; Haack, Tobias B; Prokisch, Holger; Taylor, Robert W; Ferrero, Ileana; Zeviani, Massimo; Ghezzi, Daniele

2013-01-01

294

Unexpected causes of pulmonary hypertension in a previously healthy Thai rural man with right-sided heart failure  

PubMed Central

Patient Male, 52 Final Diagnosis: Pulmonary hypertension Symptoms: Diarrhea • dyspnea • jaundice Medication: — Clinical Procedure: — Specialty: Endocrinology and Metabolic Objective: Unusual clinical course Background: Hyperthyroidism is one of the important causes of high-output failure and reversible pulmonary artery hypertension. Severe pulmonary artery hypertension is rarely found in associated with hyperthyroidism due to the small number of cases reported. We present an interesting case with multiple unexpected findings of the possible causes of severe pulmonary artery hypertension: hyperthyroidism, pulmonary embolism, and ostium secundum atrial septal defect. Case Report: We present the case of a previously healthy rural Thai man who progressively developed dyspnea on exertion, chronic diarrhea, and jaundice for the previous 3 months. Physical examination revealed right-sided predominate chronic heart failure with signs of pulmonary hypertension. The investigation demonstrated autoimmune hyperthyroidism, cholestatic jaundice, moderate tricuspid regurgitation, ostium secundum atrial septal defect, and severe pulmonary artery hypertension. After treatment with an anti-thyroid drug and closure of the ostium secundum atrial septal defect, his symptoms of jaundice and pulmonary artery pressure were completely resolved. Conclusions: Severe pulmonary artery hypertension may not solely be a result of hyperthyroidism. Further investigation for other causes is recommended. PMID:24808937

Angkananard, Teeranan; Chonmaitree, Piyanant; Petborom, Pichaya

2014-01-01

295

The economic effect of extracorporeal membrane oxygenation to support adults with severe respiratory failure in Brazil: a hypothetical analysis  

PubMed Central

Objective To analyze the cost-utility of using extracorporeal oxygenation for patients with severe acute respiratory distress syndrome in Brazil. Methods A decision tree was constructed using databases from previously published studies. Costs were taken from the average price paid by the Brazilian Unified Health System (Sistema Único de Saúde; SUS) over three months in 2011. Using the data of 10,000,000 simulated patients with predetermined outcomes and costs, an analysis was performed of the ratio between cost increase and years of life gained, adjusted for quality (cost-utility), with survival rates of 40 and 60% for patients using extracorporeal membrane oxygenation. Results The decision tree resulted in 16 outcomes with different life support techniques. With survival rates of 40 and 60%, respectively, the increased costs were R$=-301.00/-14.00, with a cost of R$=-30,913.00/-1,752.00 paid per six-month quality-adjusted life-year gained and R$=-2,386.00/-90.00 per quality-adjusted life-year gained until the end of life, when all patients with severe ARDS were analyzed. Analyzing only patients with severe hypoxemia (i.e., a ratio of partial oxygen pressure in the blood to the fraction of inspired oxygen <100mmHg), the increased cost was R$=-5,714.00/272.00, with a cost per six-month quality-adjusted life-year gained of R$=-9,521.00/293.00 and a cost of R$=-280.00/7.00 per quality-adjusted life-year gained. Conclusion The cost-utility ratio associated with the use of extracorporeal membrane oxygenation in Brazil is potentially acceptable according to this hypothetical study. PMID:25295819

Park, Marcelo; Mendes, Pedro Vitale; Zampieri, Fernando Godinho; Azevedo, Luciano Cesar Pontes; Costa, Eduardo Leite Vieira; Antoniali, Fernando; Ribeiro, Gustavo Calado de Aguiar; Caneo, Luiz Fernando; da Cruz Neto, Luiz Monteiro; Carvalho, Carlos Roberto Ribeiro; Trindade, Evelinda Marramon

2014-01-01

296

Key Performance Outcomes of Patient Safety Curricula: Root Cause Analysis, Failure Mode and Effects Analysis, and Structured Communications Skills  

PubMed Central

As colleges and schools of pharmacy develop core courses related to patient safety, course-level outcomes will need to include both knowledge and performance measures. Three key performance outcomes for patient safety coursework, measured at the course level, are the ability to perform root cause analyses and healthcare failure mode effects analyses, and the ability to generate effective safety communications using structured formats such as the Situation-Background-Assessment-Recommendation (SBAR) situational briefing model. Each of these skills is widely used in patient safety work and competence in their use is essential for a pharmacist's ability to contribute as a member of a patient safety team. PMID:22102754

2011-01-01

297

Persistent cobalamin deficiency causing failure to thrive in a juvenile beagle.  

PubMed

A six-month-old beagle was presented with a three-month history of failure to gain weight, lethargy, intermittent vomiting and seizures. Hypoglycaemia, portosystemic shunt, lead intoxication, gastrointestinal diseases and hereditary metabolic disorders were considered. Laboratory test results of low serum cobalamin (Cbl) concentrations, anaemia, leucopenia and methylmalonic aciduria while the dog was receiving a balanced commercial canine diet were suggestive of a congenital selective Cbl malabsorption. Treatment with repeated injections of parenteral cyanocobalamin (CN-Cbl) at 50 microg/kg every two weeks corrected the Cbl-deficient state and reversed all the clinical abnormalities. Selective Cbl malabsorption has previously been described in giant schnauzers and border collies and represents a unique readily treatable hereditary metabolic disorder. PMID:11023127

Fordyce, H H; Callan, M B; Giger, U

2000-09-01

298

An investigation of the causes of failure of flexible thermal protection materials in an aerodynamic environment  

NASA Technical Reports Server (NTRS)

Tests of small panels of advanced flexible reusable surface insulation (AFRSI) were conducted using a small wind tunnel that was designed to simulate Space Shuttle Orbiter entry mean-flow and pulsating aerodynamic loads. The wind tunnel, with a 3 inch wide by 1.75 inch high by 7.5 inch long test section, proved to be capable of continuous flow at dynamic pressures q near 580 psf with fluctuating pressures over 2 psi RMS at an excitation frequency f sub E of 200 Hz. For this investigation, however, the wind tunnel was used to test entry-temperature preconditioned and heat-cleaned AFRSI at q = 280 psf, Prms was nearly equal to 1.2 psi and f sub E = 200 Hz. The objective of these tests was to determine the mechanism of failure of AFRSI at Orbiter entry conditions. Details of the test apparatus and test results are presented.

Coe, Charles F.

1987-01-01

299

An investigation of the causes of failure of flexible thermal protection materials in an aerodynamic environment  

NASA Astrophysics Data System (ADS)

Tests of small panels of advanced flexible reusable surface insulation (AFRSI) were conducted using a small wind tunnel that was designed to simulate Space Shuttle Orbiter entry mean-flow and pulsating aerodynamic loads. The wind tunnel, with a 3 inch wide by 1.75 inch high by 7.5 inch long test section, proved to be capable of continuous flow at dynamic pressures q near 580 psf with fluctuating pressures over 2 psi RMS at an excitation frequency f sub E of 200 Hz. For this investigation, however, the wind tunnel was used to test entry-temperature preconditioned and heat-cleaned AFRSI at q = 280 psf, Prms was nearly equal to 1.2 psi and f sub E = 200 Hz. The objective of these tests was to determine the mechanism of failure of AFRSI at Orbiter entry conditions. Details of the test apparatus and test results are presented.

Coe, Charles F.

1987-03-01

300

Respiratory complications of organophosphorus nerve agent and insecticide poisoning. Implications for respiratory and critical care.  

PubMed

Organophosphorus (OP) compound poisoning is a major global public health problem. Acute OP insecticide self-poisoning kills over 200,000 people every year, the majority from self-harm in rural Asia. Highly toxic OP nerve agents (e.g., sarin) are a significant current terrorist threat, as shown by attacks in Damascus during 2013. These anticholinesterase compounds are classically considered to cause an acute cholinergic syndrome with decreased consciousness, respiratory failure, and, in the case of insecticides, a delayed intermediate syndrome that requires prolonged ventilation. Acute respiratory failure, by central and peripheral mechanisms, is the primary cause of death in most cases. However, preclinical and clinical research over the last two decades has indicated a more complex picture of respiratory complications after OP insecticide poisoning, including onset of delayed neuromuscular junction dysfunction during the cholinergic syndrome, aspiration causing pneumonia and acute respiratory distress syndrome, and the involvement of solvents in OP toxicity. The treatment of OP poisoning has not changed over the last 50 years. However, a better understanding of the multiple respiratory complications of OP poisoning offers additional therapeutic opportunities. PMID:25419614

Hulse, Elspeth J; Davies, James O J; Simpson, A John; Sciuto, Alfred M; Eddleston, Michael

2014-12-15

301

Molecular epidemiology of a post-influenza pandemic outbreak of acute respiratory infections in Korea caused by human adenovirus type 3.  

PubMed

An outbreak of upper respiratory tract infections associated with human adenovirus (HAdV) occurred on a national scale in Korea from September to December 2010, following a major H1N1 influenza pandemic. Data from the Korea Influenza and Respiratory Surveillance System (KINRESS) showed an unusually high positive rate accounting for up to 20% of all diagnosed cases. To determine the principal cause of the outbreak, direct polymerase chain reaction (PCR) amplification followed by sequence analysis targeting parts of the hexon gene of HAdV was performed. Serotypes of 1,007 PCR-diagnosed HAdV-positive samples from patients with an acute upper respiratory tract illness were determined and epidemiological characteristics including major aged group and clinical symptoms were analyzed. The principal symptom of HAdV infections was fever and the vulnerable aged group was 1-5 years old. Based on sequence analysis, HAdV-3 was the predominant serotype in the outbreak, with an incidence of 74.3%. From the beginning of 2010 until May, the major serotypes were HAdV-1, 2, and 5 (70-100%) in any given period. However, an outbreak dominated by HAdV-3 started between July and August and peaked in September. Phylogenetic analysis revealed that there was no genetic variation in HAdV-3. The results demonstrated that an outbreak of upper respiratory illness followed by H1N1 influenza pandemic in Korea was caused mainly by emerged HAdV-3. J. Med. Virol. 87: 10-17, 2015. © 2014 Wiley Periodicals, Inc. PMID:24889391

Lee, Wan-Ji; Jung, Hee-Dong; Cheong, Hyang-Min; Kim, Kisoon

2015-01-01

302

Phase I/II Trial of Adeno-Associated Virus–Mediated Alpha-Glucosidase Gene Therapy to the Diaphragm for Chronic Respiratory Failure in Pompe Disease: Initial Safety and Ventilatory Outcomes  

PubMed Central

Abstract Pompe disease is an inherited neuromuscular disease caused by deficiency of lysosomal acid alpha-glucosidase (GAA) leading to glycogen accumulation in muscle and motoneurons. Cardiopulmonary failure in infancy leads to early mortality, and GAA enzyme replacement therapy (ERT) results in improved survival, reduction of cardiac hypertrophy, and developmental gains. However, many children have progressive ventilatory insufficiency and need additional support. Preclinical work shows that gene transfer restores phrenic neural activity and corrects ventilatory deficits. Here we present 180-day safety and ventilatory outcomes for five ventilator-dependent children in a phase I/II clinical trial of AAV-mediated GAA gene therapy (rAAV1-hGAA) following intradiaphragmatic delivery. We assessed whether rAAV1-hGAA results in acceptable safety outcomes and detectable functional changes, using general safety measures, immunological studies, and pulmonary functional testing. All subjects required chronic, full-time mechanical ventilation because of respiratory failure that was unresponsive to both ERT and preoperative muscle-conditioning exercises. After receiving a dose of either 1×1012 vg (n=3) or 5×1012 vg (n=2) of rAAV1-hGAA, the subjects' unassisted tidal volume was significantly larger (median [interquartile range] 28.8% increase [15.2–35.2], p<0.05). Further, most patients tolerated appreciably longer periods of unassisted breathing (425% increase [103–851], p=0.08). Gene transfer did not improve maximal inspiratory pressure. Expected levels of circulating antibodies and no T-cell-mediated immune responses to the vector (capsids) were observed. One subject demonstrated a slight increase in anti-GAA antibody that was not considered clinically significant. These results indicate that rAAV1-hGAA was safe and may lead to modest improvements in volitional ventilatory performance measures. Evaluation of the next five patients will determine whether earlier intervention can further enhance the functional benefit. PMID:23570273

Smith, Barbara K.; Collins, Shelley W.; Conlon, Thomas J.; Mah, Cathryn S.; Lawson, Lee Ann; Martin, Anatole D.; Fuller, David D.; Cleaver, Brian D.; Clément, Nathalie; Phillips, Dawn; Islam, Saleem; Dobjia, Nicole

2013-01-01

303

Respiratory distress in the newborn.  

PubMed

Respiratory distress presents as tachypnea, nasal flaring, retractions, and grunting and may progress to respiratory failure if not readily recognized and managed. Causes of respiratory distress vary and may not lie within the lung. A thorough history, physical examination, and radiographic and laboratory findings will aid in the differential diagnosis. Common causes include transient tachypnea of the newborn, neonatal pneumonia, respiratory distress syndrome (RDS), and meconium aspiration syndrome (MAS). Strong evidence reveals an inverse relationship between gestational age and respiratory morbidity. (1)(2)(9)(25)(26) Expert opinion recommends careful consideration about elective delivery without labor at less than 39 weeks’ gestation. Extensive evidence, including randomized control trials, cohort studies, and expert opinion, supports maternal group B streptococcus screening, intrapartum antibiotic prophylaxis, and appropriate followup of high-risk newborns according to guidelines established by the Centers for Disease Control and Prevention. (4)(29)(31)(32)(34) Following these best-practice strategies is effective in preventing neonatal pneumonia and its complications. (31)(32)(34). On the basis of strong evidence, including randomized control trials and Cochrane Reviews, administration of antenatal corticosteroids (5) and postnatal surfactant (6) decrease respiratory morbidity associated with RDS. Trends in perinatal management strategies to prevent MAS have changed. There is strong evidence that amnioinfusion, (49) oropharyngeal and nasopharyngeal suctioning at the perineum, (45) or intubation and endotracheal suctioning of vigorous infants (46)(47) do not decrease MAS or its complications. Some research and expert opinion supports endotracheal suctioning of nonvigorous meconium-stained infants (8) and induction of labor at 41 weeks’ gestation (7) to prevent MAS. PMID:25274969

Reuter, Suzanne; Moser, Chuanpit; Baack, Michelle

2014-10-01

304

Failure of PCR-Based IS6110 Analysis To Detect Vertebral Spondylodiscitis Caused by Mycobacterium bovis  

PubMed Central

Mycobacterium bovis is responsible for a zoonosis originating in cattle. We report a case of a man with vertebral spondylodiscitis caused by Mycobacterium bovis. Diagnosis was complicated because of the lack of IS6110. These strains are rare, but microbiologists should be aware of their existence. PMID:23135943

Steensels, Deborah; Fauville-Dufaux, Maryse; Boie, Johan

2013-01-01

305

A Case of Femoral Arteriovenous Fistula Causing High-Output Cardiac Failure, Originally Misdiagnosed as Chronic Fatigue Syndrome  

PubMed Central

Percutaneous arterial catheterisation is commonly undertaken for a range of diagnostic and interventional procedures. Iatrogenic femoral arteriovenous fistulas are an uncommon complication of these procedures. Most are asymptomatic and close spontaneously, but can rarely increase in size leading to the development of symptoms. We report a case of an iatrogenic femoral arteriovenous fistula, causing worsening congestive cardiac failure, in a 34-year-old marathon runner. This was originally diagnosed as chronic fatigue syndrome. Following clinical examination, duplex ultrasound, and CT angiography a significant arteriovenous fistula was confirmed. Elective open surgery was performed, leading to a dramatic and rapid improvement in symptoms. Femoral arteriovenous fistulas have the potential to cause significant haemodynamic effects and can present many years after the initial procedure. Conservative, endovascular, and open surgical management strategies are available. PMID:24959370

Porter, J.; Al-Jarrah, Q.; Richardson, S.

2014-01-01

306

Destructive Interactions Between Mitigation Strategies and the Causes of Unexpected Failures in Natural Hazard Mitigation Systems  

NASA Astrophysics Data System (ADS)

Large investments in the mitigation of natural hazards, using a variety of technology-based mitigation strategies, have proven to be surprisingly ineffective in some recent natural disasters. These failures reveal a need for a systematic classification of mitigation strategies; an understanding of the scientific uncertainties that affect the effectiveness of such strategies; and an understanding of how the different types of strategy within an overall mitigation system interact destructively to reduce the effectiveness of the overall mitigation system. We classify mitigation strategies into permanent, responsive and anticipatory. Permanent mitigation strategies such as flood and tsunami defenses or land use restrictions, are both costly and 'brittle': when they malfunction they can increase mortality. Such strategies critically depend on the accuracy of the estimates of expected hazard intensity in the hazard assessments that underpin their design. Responsive mitigation strategies such as tsunami and lahar warning systems rely on capacities to detect and quantify the hazard source events and to transmit warnings fast enough to enable at risk populations to decide and act effectively. Self-warning and voluntary evacuation is also usually a responsive mitigation strategy. Uncertainty in the nature and magnitude of the detected hazard source event is often the key scientific obstacle to responsive mitigation; public understanding of both the hazard and the warnings, to enable decision making, can also be a critical obstacle. Anticipatory mitigation strategies use interpretation of precursors to hazard source events and are used widely in mitigation of volcanic hazards. Their critical limitations are due to uncertainties in time, space and magnitude relationships between precursors and hazard events. Examples of destructive interaction between different mitigation strategies are provided by the Tohoku 2011 earthquake and tsunami; recent earthquakes that have impacted population centers with poor enforcement of building codes, unrealistic expectations of warning systems or failures to understand local seismic damage mechanisms; and the interaction of land use restriction strategies and responsive warning strategies around lahar-prone volcanoes. A more complete understanding of the interactions between these different types of mitigation strategy, especially the consequences for the expectations and behaviors of the populations at risk, requires models of decision-making under high levels of both uncertainty and danger. The Observation-Orientation-Decision-Action (OODA) loop model (Boyd, 1987) may be a particularly useful model. It emphasizes the importance of 'orientation' (the interpretation of observations and assessment of their significance for the observer and decision-maker), the feedback between decisions and subsequent observations and orientations, and the importance of developing mitigation strategies that are flexible and so able to respond to the occurrence of the unexpected. REFERENCE: Boyd, J.R. A Discourse on Winning and Losing [http://dnipogo.org/john-r-boyd/

Day, S. J.; Fearnley, C. J.

2013-12-01

307

Pathological and ultrastructural analysis of surgical lung biopsies in patients with swine?origin influenza type A/H1N1 and acute respiratory failure  

PubMed Central

BACKGROUND: Cases of H1N1 and other pulmonary infections evolve to acute respiratory failure and death when co?infections or lung injury predominate over the immune response, thus requiring early diagnosis to improve treatment. OBJECTIVE: To perform a detailed histopathological analysis of the open lung biopsy specimens from five patients with ARDS with confirmed H1N1. METHODS: Lung specimens underwent microbiologic analysis, and examination by optical and electron microscopy. Immunophenotyping was used to characterize macrophages, natural killer, T and B cells, and expression of cytokines and iNOS. RESULTS: The pathological features observed were necrotizing bronchiolitis, diffuse alveolar damage, alveolar hemorrhage and abnormal immune response. Ultrastructural analysis showed viral?like particles in all cases. CONCLUSIONS: Viral?like particles can be successfully demonstrated in lung tissue by ultrastructural examination, without confirmation of the virus by RT?PCR on nasopharyngeal aspirates. Bronchioles and epithelium, rather than endothelium, are probably the primary target of infection, and diffuse alveolar damage the consequence of the effect of airways obliteration and dysfunction on innate immunity, suggesting that treatment should be focused on epithelial repair. PMID:21340209

Capelozzi, Vera Luiza; Parra, Edwin Roger; Ximenes, Manoel; Bammann, Ricardo Helbert; Barbas, Carmen Silvia Valente; Duarte, Marid Irmd Seixas

2010-01-01

308

Neospora caninum infection as a cause of reproductive failure in a sheep flock.  

PubMed

Neospora caninum has been detected only sporadically in cases of ovine abortion, and it has therefore traditionally been considered as an unimportant parasite in small ruminants. This study was carried out with the aim of identifying the pathogen causing serious reproductive problems on a commercial sheep farm. Sera from all rams and ewes tested negative for antibodies against Border disease virus, Schmallenberg virus and Coxiella burnetii, and infections by these agents were therefore ruled out. Nevertheless, seropositivity to N. caninum and/or Toxoplasma gondii was detected, although the seroprevalence was higher in the case of N. caninum. The percentage of lambings and the number of lambs per dam were significantly lower in ewes that were seropositive to N. caninum while no effect on these parameters was detected in ewes that were seropositive to T. gondii. There was also no evidence of infection by T. gondii in the foetal/lamb tissues analyzed by PCR and/or immunohistopathological techniques. On the contrary, the DNA of N. caninum was detected in 13 out of 14 foetuses/lambs descendant from dams seropositive to this parasite. Characteristic lesions caused by N. caninum and/or its antigen were also detected. Genotyping of the N. caninum DNA revealed only two closely related microsatellite multilocus genotypes. The results clearly demonstrate that infection by N. caninum was the cause of the low reproductive performance of this sheep flock. PMID:25158756

González-Warleta, Marta; Castro-Hermida, José Antonio; Regidor-Cerrillo, Javier; Benavides, Julio; Álvarez-García, Gema; Fuertes, Miguel; Ortega-Mora, Luis Miguel; Mezo, Mercedes

2014-01-01

309

Airway obstruction due to tracheomalacia caused by innominate artery compression and a kyphotic cervical spine.  

PubMed

Tracheomalacia can cause variable degrees of intrathoracic airway obstruction and is an easily overlooked cause of respiratory distress in adults. Here, we report a case of acute respiratory failure in which subglottic stenosis was accidentally identified during endotracheal intubation. Subsequent bronchoscopy and computed tomography of the thorax and neck revealed tracheal compression with tracheomalacia caused by a tortuous innominate artery and a kyphotic cervical spine. The patient underwent rigid bronchoscopy with metal stent implantation, and her symptoms were alleviated. These findings outline the importance of precise diagnosis and interventions for preventing recurrent life-threatening respiratory failure in such cases. PMID:25639407

Liu, Chia-Hsin; Huang, Wen-Sheng; Wang, Hong-Hau; Wu, Chin-Pyng; Chian, Chih-Feng; Perng, Wann-Cherng; Tsai, Chen-Liang

2015-02-01

310

Feasibility study on full closed-loop control ventilation (IntelliVent-ASV™) in ICU patients with acute respiratory failure: a prospective observational comparative study  

PubMed Central

Introduction IntelliVent-ASV™ is a full closed-loop ventilation mode that automatically adjusts ventilation and oxygenation parameters in both passive and active patients. This feasibility study compared oxygenation and ventilation settings automatically selected by IntelliVent-ASV™ among three predefined lung conditions (normal lung, acute respiratory distress syndrome (ARDS) and chronic obstructive pulmonary disease (COPD)) in active and passive patients. The feasibility of IntelliVent-ASV™ use was assessed based on the number of safety events, the need to switch to conventional mode for any medical reason, and sensor failure. Method This prospective observational comparative study included 100 consecutive patients who were invasively ventilated for less than 24 hours at the time of inclusion with an expected duration of ventilation of more than 12 hours. Patients were ventilated using IntelliVent-ASV™ from inclusion to extubation. Settings, automatically selected by the ventilator, delivered ventilation, respiratory mechanics, and gas exchanges were recorded once a day. Results Regarding feasibility, all patients were ventilated using IntelliVent-ASV™ (392 days in total). No safety issues occurred and there was never a need to switch to an alternative ventilation mode. The fully automated ventilation was used for 95% of the total ventilation time. IntelliVent-ASV™ selected different settings according to lung condition in passive and active patients. In passive patients, tidal volume (VT), predicted body weight (PBW) was significantly different between normal lung (n = 45), ARDS (n = 16) and COPD patients (n = 19) (8.1 (7.3 to 8.9) mL/kg; 7.5 (6.9 to 7.9) mL/kg; 9.9 (8.3 to 11.1) mL/kg, respectively; P 0.05). In passive ARDS patients, FiO2 and positive end-expiratory pressure (PEEP) were statistically higher than passive normal lung (35 (33 to 47)% versus 30 (30 to 31)% and 11 (8 to 13) cmH2O versus 5 (5 to 6) cmH2O, respectively; P< 0.05). Conclusions IntelliVent-ASV™ was safely used in unselected ventilated ICU patients with different lung conditions. Automatically selected oxygenation and ventilation settings were different according to the lung condition, especially in passive patients. Trial Registration ClinicalTrials.gov: NCT01489085 PMID:24025234

2013-01-01

311

Failure of Amino Acid Homeostasis Causes Cell Death following Proteasome Inhibition  

PubMed Central

Summary The ubiquitin-proteasome system targets many cellular proteins for degradation and thereby controls most cellular processes. Although it is well established that proteasome inhibition is lethal, the underlying mechanism is unknown. Here, we show that proteasome inhibition results in a lethal amino acid shortage. In yeast, mammalian cells, and flies, the deleterious consequences of proteasome inhibition are rescued by amino acid supplementation. In all three systems, this rescuing effect occurs without noticeable changes in the levels of proteasome substrates. In mammalian cells, the amino acid scarcity resulting from proteasome inhibition is the signal that causes induction of both the integrated stress response and autophagy, in an unsuccessful attempt to replenish the pool of intracellular amino acids. These results reveal that cells can tolerate protein waste, but not the amino acid scarcity resulting from proteasome inhibition. PMID:22959274

Suraweera, Amila; Münch, Christian; Hanssum, Ariane; Bertolotti, Anne

2012-01-01

312

Comments on serious anaphylaxis caused by nine Chinese herbal injections used to treat common colds and upper respiratory tract infections.  

PubMed

Reports describing severe allergic shock and fatality following treatment of a common cold or upper respiratory tract infection (URTI) with a Chinese herbal injection were collected. Our analysis of the risks associated with this treatment suggested that the potential risk of serious, or even lethal, anaphylaxis should preclude its use in treating common colds and URTIs. In light of our findings herein, we propose the following five suggestions for improving the clinical safety of delivering Chinese herbal injections as medical treatments. First, Chinese herbal injections should not be delivered in the clinic to treat patients in accordance with Bian zheng lun zhi (broad-spectrum application based on holistic Traditional Chinese Medicine (TCM) theory and methodology), but rather they should be administered to target specific indicated disease processes. Second, Chinese herbal injection indications should be based on the results of double-blind randomized controlled clinical trials. Third, Chinese herbal injections should be used only in cases involving severe disease or to rescue patients in critical condition; they should not be used to treat mild, relatively innocuous diseases, such as common colds and upper respiratory tract infections, given the risk of doing harm. Fourth, Chinese herbal injection formulas should include materials from only a single or a small number of plant sources in known quantities. Fifth, more studies examining the toxicology and allergenic potential of Chinese herbal injections are needed. PMID:19559066

Ji, Kunmei; Chen, Jiajie; Li, Meng; Liu, Zhigang; Xia, Lixin; Wang, Chunbo; Zhan, Zhengke; Wu, Xuli

2009-11-01

313

Goal-Directed Mechanical Ventilation: Are We Aiming at the Right Goals? A Proposal for an Alternative Approach Aiming at Optimal Lung Compliance, Guided by Esophageal Pressure in Acute Respiratory Failure  

PubMed Central

Patients with acute respiratory failure and decreased respiratory system compliance due to ARDS frequently present a formidable challenge. These patients are often subjected to high inspiratory pressure, and in severe cases in order to improve oxygenation and preserve life, we may need to resort to unconventional measures. The currently accepted ARDSNet guidelines are characterized by a generalized approach in which an algorithm for PEEP application and limited plateau pressure are applied to all mechanically ventilated patients. These guidelines do not make any distinction between patients, who may have different chest wall mechanics with diverse pathologies and different mechanical properties of their respiratory system. The ability of assessing pleural pressure by measuring esophageal pressure allows us to partition the respiratory system into its main components of lungs and chest wall. Thus, identifying the dominant factor affecting respiratory system may better direct and optimize mechanical ventilation. Instead of limiting inspiratory pressure by plateau pressure, PEEP and inspiratory pressure adjustment would be individualized specifically for each patient's lung compliance as indicated by transpulmonary pressure. The main goal of this approach is to specifically target transpulmonary pressure instead of plateau pressure, and therefore achieve the best lung compliance with the least transpulmonary pressure possible. PMID:23019524

Soroksky, Arie; Esquinas, Antonio

2012-01-01

314

Tissue factor pathway inhibitor prevents airway obstruction, respiratory failure and death due to sulfur mustard analog inhalation  

SciTech Connect

Sulfur mustard (SM) inhalation causes airway injury, with enhanced vascular permeability, coagulation, and airway obstruction. The objective of this study was to determine whether recombinant tissue factor pathway inhibitor (TFPI) could inhibit this pathogenic sequence. Methods: Rats were exposed to the SM analog 2-chloroethyl ethyl sulfide (CEES) via nose-only aerosol inhalation. One hour later, TFPI (1.5 mg/kg) in vehicle, or vehicle alone, was instilled into the trachea. Arterial O{sub 2} saturation was monitored using pulse oximetry. Twelve hours after exposure, animals were euthanized and bronchoalveolar lavage fluid (BALF) and plasma were analyzed for prothrombin, thrombin–antithrombin complex (TAT), active plasminogen activator inhibitor-1 (PAI-1) levels, and fluid fibrinolytic capacity. Lung steady-state PAI-1 mRNA was measured by RT-PCR analysis. Airway-capillary leak was estimated by BALF protein and IgM, and by pleural fluid measurement. In additional animals, airway cast formation was assessed by microdissection and immunohistochemical detection of airway fibrin. Results: Airway obstruction in the form of fibrin-containing casts was evident in central conducting airways of rats receiving CEES. TFPI decreased cast formation, and limited severe hypoxemia. Findings of reduced prothrombin consumption, and lower TAT complexes in BALF, demonstrated that TFPI acted to limit thrombin activation in airways. TFPI, however, did not appreciably affect CEES-induced airway protein leak, PAI-1 mRNA induction, or inhibition of the fibrinolytic activity present in airway surface liquid. Conclusions: Intratracheal administration of TFPI limits airway obstruction, improves gas exchange, and prevents mortality in rats with sulfur mustard-analog-induced acute lung injury. - Highlights: • TFPI administration to rats after mustard inhalation reduces airway cast formation. • Inhibition of thrombin activation is the likely mechanism for limiting casts. • Rats given TFPI had improved tissue oxygenation, and mortality was prevented.

Rancourt, Raymond C., E-mail: raymond.rancourt@ucdenver.edu; Veress, Livia A., E-mail: livia.veress@ucdenver.edu; Ahmad, Aftab, E-mail: aftab.ahmad@ucdenver.edu; Hendry-Hofer, Tara B., E-mail: tara.hendry-hofer@ucdenver.edu; Rioux, Jacqueline S., E-mail: jacqueline.rioux@ucdenver.edu; Garlick, Rhonda B., E-mail: rhonda.garlick@ucdenver.edu; White, Carl W., E-mail: carl.w.white@ucdenver.edu

2013-10-01

315

[A case of agranulocytosis caused by rifampicin during treatment of tuberculous lymphadenitis in a chronic renal failure patient].  

PubMed

A 52-year-old woman was admitted to our hospital because of intermittent high fever and chronic renal failure. Computed tomography of the thorax showed swelling of the paratracheal lymph nodes that was confirmed by gallium scintigraphy. Biopsy of the supraclavicular lymph node on the right side showed necrotizing lymphadenitis with Langhans giant cells surrounded by epithelioid cells. Anti-tuberculosis treatment, including isoniazid, rifampicin, ethambutol, and pyrazinamide was initiated. One month after treatment, the patient developed agranulocytosis (white blood cell [WBC], 2100 cells/microl; neutrophils, 5%) accompanied by severe diarrhea. Bone marrow histology showed poor development of granulocytes, but no atypical cells were observed. Therefore, rifampicin was discontinued, and treatment with granulocyte colony-stimulating factor (G-CSF) was initiated. Subsequently, the white blood cell count and the proportion of neutrophils increased to 12500 cells/microL and 80%, respectively. Rifampicin in the anti-tuberculosis chemotherapy regimen was replaced with levofloxacin. This is a rare case of agranulocytosis caused by rifampicin administered during anti-tuberculosis treatment in a chronic renal failure patient. PMID:23367831

Sugiyama, Masafumi

2012-11-01

316

Root-cause failure analysis of photocurrent loss in polythiophene:fullerene-based inverted solar cells.  

PubMed

Metal oxide transport layers have played a crucial role in recent progress in organic photovoltaic (OPV) device stability. Here, we measure the stability of inverted and encapsulated polythiophene:fullerene cells with MoO3/Ag/Al composite anode in operational conditions combining solar radiation and 65 °C. Performance loss of over 50% in the first 100 h of the aging is dominated by a drop in the short-circuit current (Jsc). We reveal a concurrent loss in reflectance from 85% to 50% above 650 nm, which is below the optical gap of the used photoactive materials, hence, excluding any major degradation in the bulk of this layer. Correlating the responses of aged devices to a series of test structures comprised of ITO/ZnO cathode, MoO3/Ag, and MoO3/Ag/Al anodes and their combinations with the active layer allowed us to identify that the presence of Al causes the reduced reflectance in these devices, independent of the presence of the active layer. Systematic single-stress aging on the test structures further indicates that elevated heat is the cause of the reflectance loss. Cross-section transmission electron microscopy coupled with elemental analysis revealed the unsuspected role of Al; notably, it diffuses through the entire 150 nm thick Ag layer and accumulates at the MoO3/Ag interface. Moreover, XRD analysis of the aged MoO3/Ag/Al anode indicates the formation of Ag2Al alloy. Depth profiling with X-ray photoelectron spectroscopy advanced our understanding by confirming the formation of Ag-Al intermetallic alloy and the presence of oxidized Al only at the MoO3/Ag interface suggesting a concomitant reduction of MoO3 to most probably MoO2. This latter compound is less reflective than MoO3, which can explain the reduced reflectance in aged devices as proven by optical simulations. On the basis of these results, we could estimate that 20% of the loss in Jsc is ascribed to reduction of MoO3 triggered by its direct contact with Al. PMID:25536872

Voroshazi, Eszter; Uytterhoeven, Griet; Cnops, Kjell; Conard, Thierry; Favia, Paola; Bender, Hugo; Muller, Robert; Cheyns, David

2015-01-14

317

Respiratory disease caused by Mycoplasma bovis is enhanced by exposure to bovine herpes virus 1 (BHV-1) but not to bovine viral diarrhea virus (BVDV) type 2  

PubMed Central

To determine if previous exposure to bovine viral diarrhea virus (BVDV) and bovine herpes virus 1 (BHV-1) type 2 affects the onset of disease caused by Mycoplasma bovis, 6- to 8-month-old beef calves were exposed to BVDV or BHV-1 4 d prior to challenge with a suspension of 3 clinical isolates of M. bovis. Animals were observed for clinical signs of disease and at necropsy, percent abnormal lung tissue and presence of M. bovis were determined. Most animals pre-exposed to BHV-1 type 2 but not BVDV developed M. bovis-related respiratory illness. In a second trial, we determined that a 100-fold reduction in the number of M. bovis bacteria administered to BHV-1 exposed animals reduced the percentage of abnormal lung tissue but not the severity of clinical signs. We conclude that previous exposure to BHV-1 but not BVDV type 2 was a necessary cause of M. bovis-related respiratory diseases in our disease model. PMID:22547839

Prysliak, Tracy; van der Merwe, Jacques; Lawman, Zoe; Wilson, Donald; Townsend, Hugh; van Drunen Littel-van den Hurk, Sylvia; Perez-Casal, José

2011-01-01

318

Continuous positive airway pressure and noninvasive ventilation in prehospital treatment of patients with acute respiratory failure: a systematic review of controlled studies.  

PubMed

Continuous positive airway pressure (CPAP) and noninvasive ventilation (NIV) are frequently used inhospital for treating respiratory failure, especially in treatment of acute cardiogenic pulmonary edema and exacerbation of chronic obstructive pulmonary disease. Early initiation of treatment is important for success and introduction already in the prehospital setting may be beneficial. Our goal was to assess the evidence for an effect of prehospital CPAP or NIV as a supplement to standard medical treatment alone on the following outcome measures; mortality, hospital length of stay, intensive care unit length of stay, and intubation rate. We undertook a systematic review based on a search in the three databases: PubMed, EMBASE, and Cochrane. We included 12 studies in our review, but only four of these were of acceptable size and quality to conclude on our endpoints of interest. All four studies examine prehospital CPAP. Of these, only one small, randomized controlled trial shows a reduced mortality rate and a reduced intubation rate with supplemental CPAP. The other three studies have neutral findings, but in two of these a trend toward lower intubation rate is found. The effect of supplemental NIV has only been evaluated in smaller studies with insufficient power to conclude on our endpoints. None of these studies have shown an effect on neither mortality nor intubation rate, but two small, randomized controlled trials show a reduction in intensive care unit length of stay and a trend toward lower intubation rate. The risk of both type two errors and publication bias is evident, and the findings are not consistent enough to make solid conclusion on supplemental prehospital NIV. Large, randomized controlled trials regarding the effect of NIV and CPAP as supplement to standard medical treatment alone, in the prehospital setting, are needed. PMID:25416493

Bakke, Skule A; Botker, Morten T; Riddervold, Ingunn S; Kirkegaard, Hans; Christensen, Erika F

2014-11-22

319

Exploitation of Diagnostic Computed Tomography Scans to Assess the Impact of Nutritional Support on Body Composition Changes in Respiratory Failure Patients  

PubMed Central

Background Assessment of nutritional status in intensive care unit (ICU) patients is limited. Computed tomography (CT) scans that include the first to fifth lumbar region completed for diagnostic purposes measures fat and lean body mass (LBM) depots and are frequently done in ICU populations and can be used to quantify fat and LBM depots. The purpose of this study was to assess if these scans could measure change in skeletal muscle (SKT), visceral adipose (VAT), and intermuscular adipose (IMAT) tissue and to examine the association between the amount of energy and protein received and changes in these depots. Methods Cross-sectional area of SKT, VAT, and IMAT from CT scans at the third lumbar region was quantified at 2 time points (CT1 and CT2). Change scores between CT1 and CT2 for each of these depots and the percentage of estimated energy/protein needs received were determined in 33 adults that with acute respiratory failure. Descriptive statistics and multiple regression was used to evaluate the influence of baseline characteristics and the percentage energy/protein needs received between CT1 and CT2 on percentage change/day between CT1 and CT2 on SKM, IMAT, and VAT. Results Participants were on average (SD) 59.7 (16) years old, received 41% of energy and 57% of protein needs. The average time between CT1 and CT2 was 10 (5) days. SKM declined 0.49%/day (men P = .07, women P = .09) and percentage of energy needs received reduced loss (? = 0.024, P = .03). No change in VAT or IMAT occurred. Conclusions CT scans can be exploited to assess change in body composition in ICU patients and may assist in detecting the causal link between nutritional support and outcomes in future clinical trials. PMID:23976767

Braunschweig, Carol A.; Sheean, Patricia M.; Peterson, Sarah J.; Perez, Sandra Gomez; Freels, Sally; Troy, Karen L.; Ajanaku, Folabomi C.; Patel, Ankur; Sclamberg, Joy S.; Wang, Zebin

2014-01-01

320

Mutations in CYC1, Encoding Cytochrome c1 Subunit of Respiratory Chain Complex III, Cause Insulin-Responsive Hyperglycemia  

PubMed Central

Many individuals with abnormalities of mitochondrial respiratory chain complex III remain genetically undefined. Here, we report mutations (c.288G>T [p.Trp96Cys] and c.643C>T [p.Leu215Phe]) in CYC1, encoding the cytochrome c1 subunit of complex III, in two unrelated children presenting with recurrent episodes of ketoacidosis and insulin-responsive hyperglycemia. Cytochrome c1, the heme-containing component of complex III, mediates the transfer of electrons from the Rieske iron-sulfur protein to cytochrome c. Cytochrome c1 is present at reduced levels in the skeletal muscle and skin fibroblasts of affected individuals. Moreover, studies on yeast mutants and affected individuals’ fibroblasts have shown that exogenous expression of wild-type CYC1 rescues complex III activity, demonstrating the deleterious effect of each mutation on cytochrome c1 stability and complex III activity. PMID:23910460

Gaignard, Pauline; Menezes, Minal; Schiff, Manuel; Bayot, Aurélien; Rak, Malgorzata; Ogier de Baulny, Hélène; Su, Chen-Hsien; Gilleron, Mylene; Lombes, Anne; Abida, Heni; Tzagoloff, Alexander; Riley, Lisa; Cooper, Sandra T.; Mina, Kym; Sivadorai, Padma; Davis, Mark R.; Allcock, Richard J.N.; Kresoje, Nina; Laing, Nigel G.; Thorburn, David R.; Slama, Abdelhamid; Christodoulou, John; Rustin, Pierre

2013-01-01

321

Virus structure. Structure and inhibition of EV-D68, a virus that causes respiratory illness in children.  

PubMed

Enterovirus D68 (EV-D68) is a member of Picornaviridae and is a causative agent of recent outbreaks of respiratory illness in children in the United States. We report here the crystal structures of EV-D68 and its complex with pleconaril, a capsid-binding compound that had been developed as an anti-rhinovirus drug. The hydrophobic drug-binding pocket in viral protein 1 contained density that is consistent with a fatty acid of about 10 carbon atoms. This density could be displaced by pleconaril. We also showed that pleconaril inhibits EV-D68 at a half-maximal effective concentration of 430 nanomolar and might, therefore, be a possible drug candidate to alleviate EV-D68 outbreaks. PMID:25554786

Liu, Yue; Sheng, Ju; Fokine, Andrei; Meng, Geng; Shin, Woong-Hee; Long, Feng; Kuhn, Richard J; Kihara, Daisuke; Rossmann, Michael G

2015-01-01

322

Postmortem volumetric CT data analysis of pulmonary air/gas content with regard to the cause of death for investigating terminal respiratory function in forensic autopsy.  

PubMed

Postmortem CT (PMCT) is useful to investigate air/gas distribution and content in body cavities and viscera. The present study investigated the procedure to estimate total lung air/gas content and aeration ratio as possible indices of terminal respiratory function, using three-dimensional (3-D) PMCT data analysis of forensic autopsy cases without putrefactive gas formation (within 3 days postmortem, n=75), and analyzed the volumetric data with regard to the cause of death. When 3-D bilateral lung images were reconstructed using an image analyzer, combined lung volume was larger in drowning (n=12) than in alcohol/sedative-hypnotic intoxication (n=8) and sudden cardiac death (SCD; n=10), and intermediate in other cases, including mechanical asphyxiation (n=12), fire fatalities due to burns (n=6) and carbon monoxide intoxication (n=7), fatal methamphetamine abuse (n=7), hyperthermia (heatstroke; n=6) and fatal hypothermia (cold exposure; n=7). Air/gas content of the lung as detected using HU interval between -2000 and -400 ('effective' lung aeration areas) and between -2000 and -191 (total lung aeration areas) as well as the ratios to total lung volume ('effective' and total lung aeration ratios, respectively) was higher in mechanical asphyxiation, drowning, fatal burns and hypothermia (cold exposure) than in SCD, and was intermediate in other cases. 'Effective' and total lung aeration ratios may be useful for comparisons between specific causes of death to discriminate between hypothermia (cold exposure) and drug intoxication, and between SCD and other causes of death, respectively. These findings provide interesting insights into potential efficacy of PMCT data analyses of lung volume and CT density as well as lung air/gas content and aeration ratio with regard to the cause of death, as possible indicators of terminal respiratory function, as part of virtual autopsy of the viscera in situ. PMID:24905153

Sogawa, Nozomi; Michiue, Tomomi; Ishikawa, Takaki; Kawamoto, Osamu; Oritani, Shigeki; Maeda, Hitoshi

2014-08-01

323

Complement and experimental respiratory failure  

Microsoft Academic Search

Activation of the complement system within the lung can lead to acute pulmonary damage and dysfunction. Based on a variety of experimental models it is now apparent that lung injury is related to complement-induced generation of oxygen derived free radicals from neutrophils and from macrophages. In addition to the oxygen radicals, it is also possible that the conversion of hydrogen

P. A. Ward; K. J. Johnson; G. O. Till

1986-01-01

324

How Is Respiratory Failure Diagnosed?  

MedlinePLUS

... estimate how much oxygen is in your blood. Arterial blood gas test. This test measures the oxygen and carbon dioxide levels in your blood. A blood sample is taken from an artery, usually in your wrist. The sample is then ...

325

Living donor liver transplantation for acute liver failure in pediatric patients caused by the ingestion of fireworks containing yellow phosphorus.  

PubMed

Yellow phosphorus is a protoplasmic toxicant that targets the liver. The ingestion of fireworks containing yellow phosphorus, either by children who accidentally consume them or by adults who are attempting suicide, often results in death due to acute liver failure (ALF). We present the outcomes of 10 children who ingested fireworks containing yellow phosphorus. There were 6 boys and 4 girls, and their ages ranged from 21 to 60 months. One patient remained stable without liver complications and was discharged. Three patients died of hepatorenal failure and cardiovascular collapse, and living donor liver transplantation (LDLT) was performed for 6 patients. The patients had grade II or III encephalopathy, a mean alanine aminotransferase level of 1148.2 IU/L, a mean aspartate aminotransferase level of 1437.5 IU/L, a mean total bilirubin level of 6.9 mg/dL, a mean international normalized ratio of 6.6, a mean Pediatric End-Stage Liver Disease score of 33.7, and a mean Child-Pugh score of 11.3. Postoperatively, 2 patients had persistent encephalopathy and died on the second or third postoperative day, and 1 patient died of cardiac arrest on the first postoperative day despite a well-functioning graft. The other 3 patients were still alive at a mean of 204 days. In conclusion, the ingestion of fireworks containing yellow phosphorus causes ALF with a high mortality rate. When signs of irreversible ALF are detected, emergency LDLT should be considered as a lifesaving procedure; however, if yellow phosphorus toxicity affects both the brain and the heart in addition to the liver, the mortality rate remains very high despite liver transplantation. PMID:21761550

Ates, Mustafa; Dirican, Abuzer; Ozgor, Dincer; Aydin, Cemalettin; Isik, Burak; Ara, Cengiz; Yilmaz, Mehmet; Ayse Selimoglu, M; Kayaalp, Cuneyt; Yilmaz, Sezai

2011-11-01

326

Novel mouse model of left ventricular pressure overload and infarction causing predictable ventricular remodelling and progression to heart failure.  

PubMed

Mouse surgical models are important tools for evaluating mechanisms of human cardiac disease. The clinically relevant comorbidities of hypertension and ischaemia have not been explored in mice. We have developed a surgical approach that combines transverse aortic constriction and distal left anterior coronary ligation (MI) to produce a gradual and predictable progression of adverse left ventricular (LV) remodelling that leads to heart failure (HF). Mice received either sham, MI alone, transverse aortic constriction alone or HF surgery. Infarct size and LV remodelling were evaluated by serial 2-D echocardiograms. Transverse aortic constriction gradients were measured by the Doppler velocity-time integral ratio between constricted and proximal aortic velocities. At 4 weeks, hearts were weighed and analysed for histology and brain natriuretic peptide, a molecular marker of HF. Echocardiographic analysis of segmental wall motion scores showed similarly small apical infarct sizes in the MI and HF groups at day 1 postsurgery. MI alone showed little change in infarct size over 4 weeks (0.26 ± 0.02 to 0.27 ± 0.04, P = 0.77); however, HF mice showed infarct expansion (0.25 ± 0.06 to 0.39 ± 0.09, P < 0.05). HF mice also showed LV remodelling with increases in LV volumes (1 day = 36.5 ± 5.2 mL, 28 days = 89.1 ± 16.0 mL) versus no significant changes in the other groups. Furthermore, systolic function progressively deteriorated in the HF group only (ejection fraction, 1 day = 55.6 ± 3.6%, 28 days = 17.6 ± 4.1%, P < 0.05) with an increase of brain natriuretic peptide by 3.5-fold. This surgical model of pressure overload in the setting of a small infarction causes progressive deterioration of cardiac structural and functional properties, and provides a clinically relevant tool to study adverse LV remodelling and heart failure. PMID:25311547

Weinheimer, Carla J; Lai, Ling; Kelly, Daniel P; Kovacs, Attila

2015-01-01

327

B?Type Natriuretic Peptide Predicts 30?Day Readmission for Heart Failure but not Readmission for Other Causes  

PubMed Central

Background B?type natriuretic peptide (BNP) is a marker for heart failure (HF) severity, but its association with hospital readmission is not well defined. Methods and Results We identified all hospital discharges (n=109 875) with a primary diagnosis of HF in the Veterans Affairs Health Care System from 2006 to 2009. We examined the association between admission (n=53 585), discharge (n=24 326), and change in BNP (n=7187) and 30?day readmission for HF or other causes. Thirty?day HF readmission was associated with elevated admission BNP, elevated discharge BNP, and smaller percent change in BNP from admission to discharge. Patients with a discharge BNP ?1000 ng/L had an unadjusted 30?day HF readmission rate over 3 times as high as patients whose discharge BNP was ?200 ng/L (15% vs. 4.1%). BNP improved discrimination and risk classification for 30?day HF readmission when added to a base clinical model, with discharge BNP having the greatest effect (C?statistic, 0.639 to 0.664 [P<0.0001]; net reclassification improvement, 9% [P<0.0001]). In contrast, 30?day readmission for non?HF causes was not associated with BNP levels during index HF hospitalization. Conclusions In this study of over 50 000 veterans hospitalized with a primary diagnosis of HF, BNP levels measured during hospitalization were associated with 30?day HF readmission, but not readmissions for other causes. These data may help guide future study aimed at identifying the optimal timing for hospital discharge and help allocate high?intensity, HF?specific transitional care interventions to the patients most likely to benefit. PMID:24922626

Flint, Kelsey M.; Allen, Larry A.; Pham, Michael; Heidenreich, Paul A.

2014-01-01

328

What Causes Heart Failure?  

MedlinePLUS

... likely that blood clots will form in your arteries. Blood clots can partially or completely block blood flow. ... Blood Pressure Blood pressure is the force of blood pushing against the walls of the arteries. If this pressure rises and stays high over ...

329

Respiratory involvement in inherited primary muscle conditions  

PubMed Central

Patients with inherited muscle disorders can develop respiratory muscle weakness leading to ventilatory failure. Predicting the extent of respiratory involvement in the different types of inherited muscle disorders is important, as it allows clinicians to impart prognostic information and offers an opportunity for early interventional management strategies. The approach to respiratory assessment in patients with muscle disorders, the current knowledge of respiratory impairment in different muscle disorders and advice on the management of respiratory complications are summarised. PMID:16980655

Shahrizaila, N; Kinnear, W J M; Wills, A J

2006-01-01

330

Effect of inhaled nitric oxide on respiratory mechanics in ventilated infants with RSV bronchiolitis  

Microsoft Academic Search

Objective: To evaluate the bronchodilator effect of inhaled nitric oxide (NO) in infants with respiratory failure caused by respiratory\\u000a syncytial virus (RSV) bronchiolitis and to compare the effect with the one obtained by salbutamol. Design: Prospective study. Setting: Pediatric intensive care unit of a university children's hospital. Patients: Twelve acutely ill, intubated infants (mean age 4.5 months, mean weight 4.9

N. R. Patel; J. Hammer; S. Nichani; A. Numa; C. J. L. Newth

1999-01-01

331

Mechanical analysis of congestive heart failure caused by bundle branch block based on an electromechanical canine heart model.  

PubMed

Asynchronous electrical activation, induced by bundle branch block (BBB), can cause reduced ventricular function. However, the effects of BBB on the mechanical function of heart are difficult to assess experimentally. Many heart models have been developed to investigate cardiac properties during BBB but have mainly focused on the electrophysiological properties. To date, the mechanical function of BBB has not been well investigated. Based on a three-dimensional electromechanical canine heart model, the mechanical properties of complete left and right bundle branch block (LBBB and RBBB) were simulated. The anatomical model as well as the fiber orientations of a dog heart was reconstructed from magnetic resonance imaging (MRI) and diffusion tensor MRI (DT-MRI). Using the solutions of reaction-diffusion equations and with a strategy of parallel computation, the asynchronous excitation propagation and intraventricular conduction in BBB was simulated. The mechanics of myocardial tissues were computed with time-, sarcomere length-dependent uniaxial active stress initiated at the time of depolarization. The quantification of mechanical intra- and interventricular asynchrony of BBB was then investigated using the finite-element method with an eight-node isoparametric element. The simulation results show that (1) there exists inter- and intraventricular systolic dyssynchrony during BBB; (2) RBBB may have more mechanical synchrony and better systolic function of the left ventricle (LV) than LBBB; (3) the ventricles always move toward the early-activated ventricle; and (4) the septum experiences higher stress than left and right ventricular free walls in BBB. The simulation results validate clinical and experimental recordings of heart deformation and provide regional quantitative estimates of ventricular wall strain and stress. The present work suggests that an electromechanical heart model, incorporating real geometry and fiber orientations, may be helpful for better understanding of the mechanical implications of congestive heart failure (CHF) caused by BBB. PMID:19098354

Dou, Jianhong; Xia, Ling; Zhang, Yu; Shou, Guofa; Wei, Qing; Liu, Feng; Crozier, Stuart

2009-01-21

332

Mucolipin Co-deficiency Causes Accelerated Endolysosomal Vacuolation of Enterocytes and Failure-to-Thrive from Birth to Weaning  

PubMed Central

During the suckling period, intestinal enterocytes are richly endowed with endosomes and lysosomes, which they presumably utilize for the uptake and intracellular digestion of milk proteins. By weaning, mature intestinal enterocytes replace those rich in lysosomes. We found that mouse enterocytes before weaning express high levels of two endolysosomal cation channels, mucolipins 3 and 1 -products of Trpml3 and Trpml1 genes; moreover neonatal enterocytes of mice lacking both mucolipins (Trpml3?/?;Trpml1?/?) vacuolated pathologically within hours of birth and remained so until weaning. Ultrastructurally and chemically these fast-forming vacuoles resembled those that systemically appear in epithelial cells of mucolipidosis type IV (MLIV) patients, which bear mutations in Trpml1. Hence, lack of both mucolipins 1 and 3 causes an accelerated MLIV-type of vacuolation in enterocytes. The vacuoles were aberrant hybrid organelles with both endosomal and lysosomal components, and were not generated by alterations in endocytosis or exocytosis, but likely by an imbalance between fusion of lysosomes and endosomes and their subsequent scission. However, upon extensive vacuolation enterocytes displayed reduced endocytosis from the intestinal lumen, a defect expected to compromise nutrient uptake. Mice lacking both mucolipins suffered a growth delay that began after birth and continued through the suckling period but recovered after weaning, coinciding with the developmental period of enterocyte vacuolation. Our results demonstrate genetic redundancy between lysosomal mucolipins 3 and 1 in neonatal enterocytes. Furthermore, our Trpml3?/?;Trpml1?/? mice represent a polygenic animal model of the poorly-understood, and often intractable, neonatal failure-to-thrive with intestinal pathology. Our results implicate lysosomes in neonatal intestinal pathologies, a major cause of infant mortality worldwide, and suggest transient intestinal dysfunction might affect newborns with lysosomal storage disorders. Finally, we conclude that mucolipin-endowed lysosomes in the young play an evolutionarily-conserved role in the intracellular digestion of maternally-provided nutrients, whether milk in mammals or yolk in oviparous species. PMID:25521295

Castiglioni, Andrew J.; Flores, Emma N.; Cantú, Jorge A.; García-Añoveros, Jaime

2014-01-01

333

Mechanical analysis of congestive heart failure caused by bundle branch block based on an electromechanical canine heart model  

NASA Astrophysics Data System (ADS)

Asynchronous electrical activation, induced by bundle branch block (BBB), can cause reduced ventricular function. However, the effects of BBB on the mechanical function of heart are difficult to assess experimentally. Many heart models have been developed to investigate cardiac properties during BBB but have mainly focused on the electrophysiological properties. To date, the mechanical function of BBB has not been well investigated. Based on a three-dimensional electromechanical canine heart model, the mechanical properties of complete left and right bundle branch block (LBBB and RBBB) were simulated. The anatomical model as well as the fiber orientations of a dog heart was reconstructed from magnetic resonance imaging (MRI) and diffusion tensor MRI (DT-MRI). Using the solutions of reaction-diffusion equations and with a strategy of parallel computation, the asynchronous excitation propagation and intraventricular conduction in BBB was simulated. The mechanics of myocardial tissues were computed with time-, sarcomere length-dependent uniaxial active stress initiated at the time of depolarization. The quantification of mechanical intra- and interventricular asynchrony of BBB was then investigated using the finite-element method with an eight-node isoparametric element. The simulation results show that (1) there exists inter- and intraventricular systolic dyssynchrony during BBB; (2) RBBB may have more mechanical synchrony and better systolic function of the left ventricle (LV) than LBBB; (3) the ventricles always move toward the early-activated ventricle; and (4) the septum experiences higher stress than left and right ventricular free walls in BBB. The simulation results validate clinical and experimental recordings of heart deformation and provide regional quantitative estimates of ventricular wall strain and stress. The present work suggests that an electromechanical heart model, incorporating real geometry and fiber orientations, may be helpful for better understanding of the mechanical implications of congestive heart failure (CHF) caused by BBB.

Dou, Jianhong; Xia, Ling; Zhang, Yu; Shou, Guofa; Wei, Qing; Liu, Feng; Crozier, Stuart

2009-01-01

334

Proper Criteria of Nonlinear Optical Crystals for Space Laser Systems and the Possible Causes for Space Laser Failures  

NASA Technical Reports Server (NTRS)

NASA is striving to develop a scientific understanding of the universe and the Earth-Sun System and its response to natural or human-induced changes. Space lasers are vital tools for NASA's missions to advance our understanding of space research and improving our prediction capability for climate, weather, and natural hazards. Unfortunately, several past space missions that utilized lasers proved to be short-lived and unreliable. In this paper, we are reporting the results of our investigations on several nonlinear optical crystals, which are vital components in space lasers. Examples of these investigations are: The correlation of the phase diagrams of nonlinear crystals and its durability, the effect of radiating these crystals by high-energy beams of protons and gamma on their second harmonic efficiency, and measurements of the high-energy and low-energy thresholds for each crystal before and after irradiation. A set of proper criteria for these crystals will be presented. We will also discuss the possible causes of failures in a space laser and propose a solution to a contamination problem in all future space lasers.

Abdeldayem, Hossin A.; Dowdye, Edward; Jamison, Tracee; Canham, John

2005-01-01

335

High Rate of Per Oral Mecillinam Treatment Failure in Community-Acquired Urinary Tract Infections Caused by ESBL-Producing Escherichia coli  

PubMed Central

A population-based study was performed to investigate the efficacy of mecillinam treatment of community-acquired urinary tract infections (CA-UTI) caused by extended-spectrum ?-lactamase (ESBL) producing Escherichia coli. The study was conducted in South-Eastern Norway. Data from patients with CA-UTI caused by ESBL-producing and non-producing (random controls) E. coli were collected through interviews, questionnaires, medical records and the Norwegian Prescription Database. Treatment failure was defined as a new antibiotic prescription appropriate for UTI prescribed within two weeks after the initial antimicrobial therapy. Multivariable logistic regression analysis was performed to identify treatment agents and patient- or bacterial traits associated with treatment failure. A total of 343 patients (mean age 59) were included, of which 158 (46%) were treated with mecillinam. Eighty-one patients (24%, mean age 54) had infections caused by ESBL producing E. coli, and 41 of these patients (51%) received mecillinam as the primary treatment. Mecillinam treatment failure was observed in 18 (44%) of patients infected by ESBL-producing strains and in 16 (14%) of patients with a CA-UTI caused by ESBL non-producing strains. Multivariable analysis showed that ESBL status (odds ratio (OR) 3.2, 95% confidence interval (CI) 1.3–7.8, p?=?0.009) and increased MIC of mecillinam (OR 2.0 for each doubling value of MIC, CI 1.4–3.0, p<0.001) were independently associated with mecillinam treatment failure. This study showed a high rate of mecillinam treatment failure in CA-UTIs caused by ESBL producing E. coli. The high failure rate could not be explained by the increased MIC of mecillinam alone. Further studies addressing the use of mecillinam against ESBL-producing E. coli, with emphasis on optimal dosing and combination therapy with ?-lactamase inhibitors, are warranted. PMID:24454943

Søraas, Arne; Sundsfjord, Arnfinn; Jørgensen, Silje Bakken; Liestøl, Knut; Jenum, Pål A.

2014-01-01

336

Human Respiratory Syncytial Virus Memphis 37 Grown in HEp-2 Cells Causes more Severe Disease in Lambs than Virus Grown in Vero Cells  

PubMed Central

Respiratory syncytial virus (RSV) is the most common cause of bronchiolitis in infants and young children. A small percentage of these individuals develop severe and even fatal disease. To better understand the pathogenesis of severe disease and develop therapies unique to the less-developed infant immune system, a model of infant disease is needed. The neonatal lamb pulmonary development and physiology is similar to that of infants, and sheep are susceptible to ovine, bovine, or human strains of RSV. RSV grown in Vero (African green monkey) cells has a truncated attachment G glycoprotein as compared to that grown in HEp-2 cells. We hypothesized that the virus grown in HEp-2 cells would cause more severe clinical symptoms and cause more severe pathology. To confirm the hypothesis, lambs were inoculated simultaneously by two different delivery methods (intranasal and nebulized inoculation) with either Vero-grown or HEp-2-grown RSV Memphis 37 (M37) strain of virus to compare viral infection and disease symptoms. Lambs infected with HEp-2 cell-derived virus by either intranasal or nebulization inoculation had significantly higher levels of viral RNA in lungs as well as greater clinical disease including both gross and histopathologic lesions compared to lambs similarly inoculated with Vero-grown virus. Thus, our results provide convincing in vivo evidence for differences in viral infectivity that corroborate previous in vitro mechanistic studies demonstrating differences in the G glycoprotein expression by RSV grown in Vero cells. PMID:24284879

Derscheid, Rachel J.; van Geelen, Albert; McGill, Jodi L.; Gallup, Jack M.; Cihlar, Tomas; Sacco, Randy E.; Ackermann, Mark R.

2013-01-01

337

On the Over-Emphasis of Human `Error' As A Cause of Aviation Accidents: `Systemic Failures' and `Human Error' in US NTSB and Canadian TSB Aviation Reports  

E-print Network

-1- On the Over-Emphasis of Human `Error' As A Cause of Aviation Accidents: `Systemic Failures://shemesh.larc.nasa.gov/people/cmh/. Keywords: Human Error, Causal Analysis, Accident Investigation, and Accident Analysis. Abstract It has been claimed that up to 80% of all aviation accidents are attributed to human `error' (Johnson, 2003). This has

Johnson, Chris

338

BEEHAVE: a systems model of honeybee colony dynamics and foraging to explore multifactorial causes of colony failure  

PubMed Central

A notable increase in failure of managed European honeybee Apis mellifera L. colonies has been reported in various regions in recent years. Although the underlying causes remain unclear, it is likely that a combination of stressors act together, particularly varroa mites and other pathogens, forage availability and potentially pesticides. It is experimentally challenging to address causality at the colony scale when multiple factors interact. In silico experiments offer a fast and cost-effective way to begin to address these challenges and inform experiments. However, none of the published bee models combine colony dynamics with foraging patterns and varroa dynamics. We have developed a honeybee model, BEEHAVE, which integrates colony dynamics, population dynamics of the varroa mite, epidemiology of varroa-transmitted viruses and allows foragers in an agent-based foraging model to collect food from a representation of a spatially explicit landscape. We describe the model, which is freely available online (www.beehave-model.net). Extensive sensitivity analyses and tests illustrate the model's robustness and realism. Simulation experiments with various combinations of stressors demonstrate, in simplified landscape settings, the model's potential: predicting colony dynamics and potential losses with and without varroa mites under different foraging conditions and under pesticide application. We also show how mitigation measures can be tested. Synthesis and applications. BEEHAVE offers a valuable tool for researchers to design and focus field experiments, for regulators to explore the relative importance of stressors to devise management and policy advice and for beekeepers to understand and predict varroa dynamics and effects of management interventions. We expect that scientists and stakeholders will find a variety of applications for BEEHAVE, stimulating further model development and the possible inclusion of other stressors of potential importance to honeybee colony dynamics. PMID:25598549

Becher, Matthias A; Grimm, Volker; Thorbek, Pernille; Horn, Juliane; Kennedy, Peter J; Osborne, Juliet L

2014-01-01

339

Re-emergent Human Adenovirus Genome Type 7d Caused an Acute Respiratory Disease Outbreak in Southern China After a Twenty-one Year Absence  

PubMed Central

Human adenoviruses (HAdVs) are highly contagious pathogens causing acute respiratory disease (ARD), among other illnesses. Of the ARD genotypes, HAdV-7 presents with more severe morbidity and higher mortality than the others. We report the isolation and identification of a genome type HAdV-7d (DG01_2011) from a recent outbreak in Southern China. Genome sequencing, phylogenetic analysis, and restriction endonuclease analysis (REA) comparisons with past pathogens indicate HAdV-7d has re-emerged in Southern China after an absence of twenty-one years. Recombination analysis reveals this genome differs from the 1950s-era prototype and vaccine strains by a lateral gene transfer, substituting the coding region for the L1 52/55?kDa DNA packaging protein from HAdV-16. DG01_2011 descends from both a strain circulating in Southwestern China (2010) and a strain from Shaanxi causing a fatality and outbreak (Northwestern China; 2009). Due to the higher morbidity and mortality rates associated with HAdV-7, the surveillance, identification, and characterization of these strains in population-dense China by REA and/or whole genome sequencing are strongly indicated. With these accurate identifications of specific HAdV types and an epidemiological database of regional HAdV pathogens, along with the HAdV genome stability noted across time and space, the development, availability, and deployment of appropriate vaccines are needed. PMID:25482188

Zhao, Suhui; Wan, Chengsong; Ke, Changwen; Seto, Jason; Dehghan, Shoaleh; Zou, Lirong; Zhou, Jie; Cheng, Zetao; Jing, Shuping; Zeng, Zhiwei; Zhang, Jing; Wan, Xuan; Wu, Xianbo; Zhao, Wei; Zhu, Li; Seto, Donald; Zhang, Qiwei

2014-01-01

340

Grain dust originating from organic and conventional farming as a potential source of biological agents causing respiratory diseases in farmers  

PubMed Central

Introduction Agricultural producers are exposed to a number of different health risks associated with their work environment. Aim The objective of the study was to assess the degree of colonization by fungi in terms of quantity and in terms of variety of species the samples taken from the settled dust from combine threshing of rye cultivation from organic and conventional farms in the Province of Lublin. Material and methods This paper is a preliminary quantitative assessment of the species of fungi colonizing the samples of settled dust collected during combine threshing from organic and conventional farms in the Province of Lublin. One of the stages of the project was the classification of biosafety BSL (biosafety level) of selected isolates and API ZYM tests to evaluate the potential ability of isolates to cause adverse health effects. To determine the concentration and composition of fungi in collected samples plate dilution method was used with two media: Malt Agar and Potato Dextrose Agar. Results Most commonly isolated fungi in settled dust samples collected during combine threshing from organic farms, on PDA medium were: Alternaria alternata and Aureobasidium pullulans. Cultures on MA medium were dominated by Alternaria alternata, Mycelia sterilia and Fusarium poae. In samples of dust from conventional crops, the predominant species was Alternaria alternata on PDA medium and on MA medium. Conclusions The obtained results show a potential risk of people involved in agricultural work. PMID:24493998

Cholewa, Gra?yna; Krasowska, Ewelina; Chmielewska-Badora, Jolanta; Zwoli?ski, Jacek; Sobczak, Pawe?

2013-01-01

341

Respiratory medicine of reptiles.  

PubMed

Noninfectious and infectious causes have been implicated in the development of respiratory tract disease in reptiles. Treatment modalities in reptiles have to account for species differences in response to therapeutic agents as well as interpretation of diagnostic findings. Data on effective drugs and dosages for the treatment of respiratory diseases are often lacking in reptiles. Recently, advances have been made on the application of advanced imaging modalities, especially computed tomography for the diagnosis and treatment monitoring of reptiles. This article describes common infectious and noninfectious causes of respiratory disease in reptiles, including diagnostic and therapeutic regimen. PMID:21601811

Schumacher, Juergen

2011-05-01

342

A mid-layer model for human reliability analysis : understanding the cognitive causes of human failure events.  

SciTech Connect

The Office of Nuclear Regulatory Research (RES) at the US Nuclear Regulatory Commission (USNRC) is sponsoring work in response to a Staff Requirements Memorandum (SRM) directing an effort to establish a single human reliability analysis (HRA) method for the agency or guidance for the use of multiple methods. As part of this effort an attempt to develop a comprehensive HRA qualitative approach is being pursued. This paper presents a draft of the method's middle layer, a part of the qualitative analysis phase that links failure mechanisms to performance shaping factors. Starting with a Crew Response Tree (CRT) that has identified human failure events, analysts identify potential failure mechanisms using the mid-layer model. The mid-layer model presented in this paper traces the identification of the failure mechanisms using the Information-Diagnosis/Decision-Action (IDA) model and cognitive models from the psychological literature. Each failure mechanism is grouped according to a phase of IDA. Under each phase of IDA, the cognitive models help identify the relevant performance shaping factors for the failure mechanism. The use of IDA and cognitive models can be traced through fault trees, which provide a detailed complement to the CRT.

Shen, Song-Hua (US Nuclear Regulatory Commission, Washington, DC); Chang, James Y. H. (US Nuclear Regulatory Commission, Washington, DC); Boring,Ronald L. (Idaho National Laboratory, Idaho Falls, ID); Whaley, April M. (Idaho National Laboratory, Idaho Falls, ID); Lois, Erasmia (US Nuclear Regulatory Commission, Washington, DC); Hendrickson, Stacey M. Langfitt; Oxstrand, Johanna H. (Vattenfall Ringhals AB, Varobacka, Sweden); Forester, John Alan; Kelly, Dana L. (Idaho National Laboratory, Idaho Falls, ID); Mosleh, Ali (University of Maryland, College Park, MD)

2010-03-01

343

Porcine reproductive and respiratory syndrome.  

PubMed

In 1987, porcine reproductive and respiratory syndrome (PRRS) was recognized in the USA as a new disease of swine causing late-term reproductive failure and severe pneumonia in neonatal pigs. The syndrome is caused by an RNA virus referred to as PRRS virus (PRRSV), which is classified in the family Arteriviridae. Swine macrophages are the only indigenous cell type known to support PRRSV replication. Direct contact between infected and naive pigs is the predominant route of PRRSV transmission. Exposure of a mucosal surface to PRRSV leads to virus replication in regional macrophages, a prolonged viremia and systemic distribution of virus to other macrophage populations. Reproductive failure induced by PRRSV infection in late-gestation sows is characterized by premature farrowing of stillborn, partially autolyzed, and mummified fetuses. Pneumonia caused by PRRSV infection is more severe in young pigs compared to adults and may be complicated by concurrent bacterial infections. Gross lung lesions associated with PRRSV infection vary from none to diffuse consolidation. In addition, multiple lymph nodes may be markedly enlarged. Microscopically, PRRSV-pneumonia is characterized by multifocal, interstitial thickening by macrophages and necrotic cell debris in alveoli. Other less common microscopic lesions of PRRSV infection include myocarditis, vasculitis, encephalitis, and lymphoid hypertrophy and hyperplasia. In acute or subacute PRRSV infections, serum and lung are the best specimens for diagnosis. Persistent PRRSV infections can be produced by transplacental or intranasal infection. Persistent PRRSV infections are an important factor for virus survival and transmission within a swine herd and will complicate control programs. PMID:9545131

Rossow, K D

1998-01-01

344

Wind-Turbine Gear-Box Roller-Bearing Premature-Failure Caused by Grain-Boundary Hydrogen Embrittlement: A Multi-physics Computational Investigation  

NASA Astrophysics Data System (ADS)

To help overcome the problem of horizontal-axis wind-turbine (HAWT) gear-box roller-bearing premature-failure, the root causes of this failure are currently being investigated using mainly laboratory and field-test experimental approaches. In the present work, an attempt is made to develop complementary computational methods and tools which can provide additional insight into the problem at hand (and do so with a substantially shorter turn-around time). Toward that end, a multi-physics computational framework has been developed which combines: (a) quantum-mechanical calculations of the grain-boundary hydrogen-embrittlement phenomenon and hydrogen bulk/grain-boundary diffusion (the two phenomena currently believed to be the main contributors to the roller-bearing premature-failure); (b) atomic-scale kinetic Monte Carlo-based calculations of the hydrogen-induced embrittling effect ahead of the advancing crack-tip; and (c) a finite-element analysis of the damage progression in, and the final failure of a prototypical HAWT gear-box roller-bearing inner raceway. Within this approach, the key quantities which must be calculated using each computational methodology are identified, as well as the quantities which must be exchanged between different computational analyses. The work demonstrates that the application of the present multi-physics computational framework enables prediction of the expected life of the most failure-prone HAWT gear-box bearing elements.

Grujicic, M.; Chenna, V.; Galgalikar, R.; Snipes, J. S.; Ramaswami, S.; Yavari, R.

2014-11-01

345

Acute kidney failure  

MedlinePLUS

Kidney failure; Renal failure; Renal failure - acute; ARF; Kidney injury - acute ... There are many possible causes of kidney damage. They include: ... cholesterol (cholesterol emboli) Decreased blood flow due to very ...

346

Investigation of occupational and environmental causes of respiratory cancers (ICARE): a multicenter, population-based case-control study in France  

PubMed Central

Background Occupational causes of respiratory cancers need to be further investigated: the role of occupational exposures in the aetiology of head and neck cancers remains largely unknown, and there are still substantial uncertainties for a number of suspected lung carcinogens. The main objective of the study is to examine occupational risk factors for lung and head and neck cancers. Methods/design ICARE is a multi-center, population-based case-control study, which included a group of 2926 lung cancer cases, a group of 2415 head and neck cancer cases, and a common control group of 3555 subjects. Incident cases were identified in collaboration with cancer registries, in 10 geographical areas. The control group was a random sample of the population of these areas, with a distribution by sex and age comparable to that of the cases, and a distribution by socioeconomic status comparable to that of the population. Subjects were interviewed face to face, using a standardized questionnaire collecting particularly information on tobacco and alcohol consumption, residential history and a detailed description of occupational history. Biological samples were also collected from study subjects. The main occupational exposures of interest are asbestos, man-made mineral fibers, formaldehyde, polycyclic aromatic hydrocarbons, chromium and nickel compounds, arsenic, wood dust, textile dust, solvents, strong acids, cutting fluids, silica, diesel fumes, welding fumes. The complete list of exposures of interest includes more than 60 substances. Occupational exposure assessment will use several complementary methods: case-by-case evaluation of exposure by experts; development and use of algorithms to assess exposure from the questionnaires; application of job-exposure matrices. Discussion The large number of subjects should allow to uncover exposures associated with moderate increase in risks, and to evaluate risks associated with infrequent or widely dispersed exposures. It will be possible to study joint effects of exposure to different occupational risk factors, to examine the interactions between occupational exposures, tobacco smoking, alcohol drinking, and genetic risk factors, and to estimate the proportion of respiratory cancers attributable to occupational exposures in France. In addition, information on many non-occupational risk factors is available, and the study will provide an excellent framework for numerous studies in various fields. PMID:22171573

2011-01-01

347

Critical diaphragm failure in sudden infant death syndrome  

PubMed Central

Sudden infant death syndrome (SIDS) is the leading cause of death in infants between the ages of 1 and 12 months in developed countries. SIDS is by definition a diagnosis of exclusion, and its mechanism of action is unknown. The SIDS–Critical Diaphragm Failure (CDF) hypothesis postulates that the cause of death in SIDS is respiratory failure caused by CDF. Four principal risk factors contribute to CDF in young infants: undeveloped respiratory muscles, non-lethal infections, prone resting position, and REM sleep. Even relatively minor infections can cause an acute and significant reduction in diaphragm force generation capacity that in conjunction with other risk factors can precipitate CDF. CDF-induced acute muscle weakness leaves few, if any pathological marks on the affected tissue.Understanding the underlying mechanism of SIDS may help in formulating new approaches to child care that can help to further reduce the incidence of SIDS. PMID:21222555

2011-01-01

348

Critical diaphragm failure in sudden infant death syndrome.  

PubMed

Sudden infant death syndrome (SIDS) is the leading cause of death in infants between the ages of 1 and 12 months in developed countries. SIDS is by definition a diagnosis of exclusion, and its mechanism of action is unknown. The SIDS-Critical Diaphragm Failure (CDF) hypothesis postulates that the cause of death in SIDS is respiratory failure caused by CDF. Four principal risk factors contribute to CDF in young infants: undeveloped respiratory muscles, non-lethal infections, prone resting position, and REM sleep. Even relatively minor infections can cause an acute and significant reduction in diaphragm force generation capacity that in conjunction with other risk factors can precipitate CDF. CDF-induced acute muscle weakness leaves few, if any pathological marks on the affected tissue.Understanding the underlying mechanism of SIDS may help in formulating new approaches to child care that can help to further reduce the incidence of SIDS. PMID:21222555

Siren, Pontus Max Axel; Siren, Matti Juhani

2011-05-01

349

Protection against soman-induced neuropathology and respiratory failure: A comparison of the efficacy of diazepam and avizafone in guinea pig  

Microsoft Academic Search

The purpose of this study was to compare the efficacy of diazepam and the pro-diazepam avizafone in preventing the severity of soman-induced pathology in guinea pig. Survival, respiration and seizures of experimental animals were investigated with on-line monitoring of respiratory and EEG parameters. Guinea pigs were pretreated with pyridostigmine (0.1mg\\/kg i.m.) and 30min later challenged with 1 or 2 LD50

L. Taysse; S. Daulon; S. Delamanche; B. Bellier; P. Breton

2006-01-01

350

The Child's Understanding of the Causes of Academic Success and Failure: A Case Study of British Schoolchildren.  

ERIC Educational Resources Information Center

Examines explanations used by children (ages five-14) to explain academic success and failure; frequency of their use; and developmental variations in types of explanations used. It was found that patterns of attribution categories vary by age, and that the attribution process involves a complex interaction of subjective and objective reality.…

Little, A. W.

1985-01-01

351

Cause of failure and optimization of a V-belt pulley considering fatigue life uncertainty in automotive applications  

Microsoft Academic Search

High accuracy of dimensions and strength in design requirements are required to produce reliable automotive components with consistent strength distribution. For example, a V-belt pulley is widely used to transmit power between rotational mechanical elements. However, due to defects from the manufacturing process and heterogeneity of materials, different kinds of failure damage may occur in pulleys of identical shape and

Hee-Jin Shim; Jung-Kyu Kim

2009-01-01

352

3D spatial data mining on document sets for the discovery of failure causes in complex technical devices  

Microsoft Academic Search

The retrospective fault analysis of complex technical devices based on documents emerging in the advanced steps of the product life cycle can reveal error sources and problems, which have not been discovered by simulations or other test methods in the early stages of the product life cycle. This paper presents a novel approach to support the failure analysis through (i)

Timo Götzelmann; Knut Hartmann; Andreas Nürnberger; Thomas Strothotte

2007-01-01

353

Comparative efficacy of diazepam and avizafone against sarin-induced neuropathology and respiratory failure in guinea pigs: influence of atropine dose.  

PubMed

This investigation compared the efficacy of diazepam and the water-soluble prodiazepam-avizafone-in sarin poisoning therapy. Guinea pigs, pretreated with pyridostigmine 0.1 mg/kg, were intoxicated with 4LD(50) of sarin (s.c. route) and 1 min after intoxication treated by intramuscular injection of atropine (3 or 33.8 mg/kg), pralidoxime (32 mg/kg) and either diazepam (2 mg/kg) or avizafone (3.5 mg/kg). EEG and pneumo-physiological parameters were simultaneously recorded. When atropine was administered at a dose of 3 mg/kg, seizures were observed in 87.5% of the cases; if an anticonvulsant was added (diazepam (2 mg/kg) or avizafone (3.5 mg/kg)), seizure was prevented but respiratory disorders were observed. At 33.8 mg/kg, atropine markedly increased the seizure threshold and prevented early respiratory distress induced by sarin. When diazepam was administered together with atropine, seizures were not observed but 62.5% of the animals displayed respiratory difficulties. These symptoms were not observed when using avizafone. The pharmacokinetic data showed marked variation of the plasma levels of atropine and diazepam in different antidote combination groups, where groups receiving diazepam exhibited the lowest concentration of atropine in plasma. Taken together, the results indicate that avizafone is suitable in therapy against sarin when an anticonvulsant is judged necessary. PMID:12767691

Taysse, L; Calvet, J-H; Buée, J; Christin, D; Delamanche, S; Breton, P

2003-06-30

354

Respiratory Syncytial Virus Infection of Human Alveolar Epithelial Cells Enhances Interferon Regulatory Factor 1 and Interleukin-1?-Converting Enzyme Gene Expression but Does Not Cause Apoptosis  

PubMed Central

The induction kinetics of the transcriptional activities of interferon regulatory factor 1 (IRF-1), interleukin-1?-converting enzyme (ICE), and CPP32 by respiratory syncytial virus (RSV) infection of human type II alveolar epithelial cells (A549 cells) were analyzed semiquantitatively by reverse transcriptase PCR. The appearance of ICE and CPP32 protein in cell lysate was examined by Western blotting analysis. The induction of apoptosis by RSV infection was examined by the appearance of DNA fragmentation detected by terminal deoxynucleotidyltransferase-mediated dUTP-biotin nick end labeling. RSV moderately enhanced IRF-1 mRNA as early as 4 h after infection, and this enhancement lasted several hours. Following induction of the IRF-1 gene, ICE gene expression increased significantly, and an increase of ICE protein was observed in the RSV-infected cell lysate. These increments were observed in cells treated with live RSV but not in cells treated with inactivated RSV or control antigen. However, no infection-specific increase of CPP32 gene expression or the protein was observed. No nucleosomal fragmentation was observed in RSV-infected cells during the whole course of infection, despite the appearance of extensive cytopathic change and cell death. These observations suggest that RSV infection of human alveolar epithelial cells induces the ICE gene and its protein as a result of increased IRF-1 induction but that the increased ICE was insufficient to cause apoptosis in the RSV-infected cells. ICE might not be able to activate CPP32, which is thought to be the more important protease for apoptosis. PMID:9557748

Takeuchi, Ryoh; Tsutsumi, Hiroyuki; Osaki, Masaya; Haseyama, Keiji; Mizue, Nobuo; Chiba, Shunzo

1998-01-01

355

Livedoid Vasculopathy and Mononeuritis Multiplex, with a Fulminant Hepatic Failure which was caused by Herpes Simplex Hepatitis: A Case Report  

PubMed Central

Livedoid vasculopathy with mononeuritis multiplex is a rare association. We are presenting a case of an unusual association of livedoid vasculopathy with mononeuritis multiplex, who developed fulminant hepatic failure which was secondary to Herpes simplex virus (HSV) hepatitis, while she was on treatment with immunosuppressants. Her skin biopsy and immunofluorescence studies showed the features of vasculitis. A biopsy from the sural nerve showed the features of chronic vasculitis. PMID:23814745

Pai B, Sathish; Pai, Kanthilatha

2013-01-01

356

Livedoid Vasculopathy and Mononeuritis Multiplex, with a Fulminant Hepatic Failure which was caused by Herpes Simplex Hepatitis: A Case Report.  

PubMed

Livedoid vasculopathy with mononeuritis multiplex is a rare association. We are presenting a case of an unusual association of livedoid vasculopathy with mononeuritis multiplex, who developed fulminant hepatic failure which was secondary to Herpes simplex virus (HSV) hepatitis, while she was on treatment with immunosuppressants. Her skin biopsy and immunofluorescence studies showed the features of vasculitis. A biopsy from the sural nerve showed the features of chronic vasculitis. PMID:23814745

Pai B, Sathish; Pai, Kanthilatha

2013-05-01

357

Visceral myopathy causing chronic intestinal pseudoobstruction and intestinal failure in a child with Sanjad-Sakati syndrome.  

PubMed

Sanjad-Sakati syndrome is a rare autosomal recessive disorder mainly occurring in the Arab Peninsula. This condition is associated with metabolic and septic complications starting in the neonatal period. Chronic intestinal pseudoobstruction owing to visceral myopathy is a rare disabling condition. We report a rare concurrence of Sanjad-Sakati syndrome and chronic intestinal pseudoobstruction in a Saudi child complicated by intestinal failure, sepsis, and early mortality. PMID:20152369

Pal, Kamalesh; Moammar, Hissa; Mitra, Dilip K

2010-02-01

358

Methods of data collection and analysis for the economic evaluation alongside a national, multi-centre trial in the UK: Conventional ventilation or ECMO for Severe Adult Respiratory Failure (CESAR)  

PubMed Central

Background Extracorporeal Membrane Oxygenation (ECMO) is a technology used in treatment of patients with severe but potentially reversible respiratory failure. A multi-centre randomised controlled trial (CESAR) was funded in the UK to compare care including ECMO with conventional intensive care management. The protocol and funding for the CESAR trial included plans for economic data collection and analysis. Given the high cost of treatment, ECMO is considered an expensive technology for many funding systems. However, conventional treatment for severe respiratory failure is also one of the more costly forms of care in any health system. Methods/Design The objectives of the economic evaluation are to compare the costs of a policy of referral for ECMO with those of conventional treatment; to assess cost-effectiveness and the cost-utility at 6 months follow-up; and to assess the cost-utility over a predicted lifetime. Resources used by patients in the trial are identified. Resource use data are collected from clinical report forms and through follow up interviews with patients. Unit costs of hospital intensive care resources are based on parallel research on cost functions in UK NHS intensive care units. Other unit costs are based on published NHS tariffs. Cost effectiveness analysis uses the outcome: survival without severe disability. Cost utility analysis is based on quality adjusted life years gained based on the Euroqol EQ-5D at 6 months. Sensitivity analysis is planned to vary assumptions about transport costs and method of costing intensive care. Uncertainty will also be expressed in analysis of individual patient data. Probabilities of cost effectiveness given different funding thresholds will be estimated. Discussion In our view it is important to record our methods in detail and present them before publication of the results of the trial so that a record of detail not normally found in the final trial reports can be made available in the public domain. Trial Registrations The CESAR trial registration number is ISRCTN47279827. PMID:18447931

Thalanany, Mariamma M; Mugford, Miranda; Hibbert, Clare; Cooper, Nicola J; Truesdale, Ann; Robinson, Steven; Tiruvoipati, Ravindranath; Elbourne, Diana R; Peek, Giles J; Clemens, Felicity; Hardy, Polly; Wilson, Andrew

2008-01-01

359

Bovine Respiratory Disease Max Irsik DVM, MAB  

E-print Network

Bovine Respiratory Disease Max Irsik DVM, MAB Beef Cattle Extension Veterinarian University of Florida College of Veterinary Medicine Disease of the respiratory tract is a major problem for cattle that continues to cause serious economic losses for producers. Bovine respiratory disease (BRD) causes increased

Watson, Craig A.

360

Application of Failure Mode and Effect Analysis (FMEA), cause and effect analysis, and Pareto diagram in conjunction with HACCP to a corn curl manufacturing plant.  

PubMed

The Failure Mode and Effect Analysis (FMEA) model has been applied for the risk assessment of corn curl manufacturing. A tentative approach of FMEA application to the snacks industry was attempted in an effort to exclude the presence of GMOs in the final product. This is of crucial importance both from the ethics and the legislation (Regulations EC 1829/2003; EC 1830/2003; Directive EC 18/2001) point of view. The Preliminary Hazard Analysis and the Fault Tree Analysis were used to analyze and predict the occurring failure modes in a food chain system (corn curls processing plant), based on the functions, characteristics, and/or interactions of the ingredients or the processes, upon which the system depends. Critical Control points have been identified and implemented in the cause and effect diagram (also known as Ishikawa, tree diagram, and the fishbone diagram). Finally, Pareto diagrams were employed towards the optimization of GMOs detection potential of FMEA. PMID:17457722

Varzakas, Theodoros H; Arvanitoyannis, Ioannis S

2007-01-01

361

Detection of respiratory pathogens in aerosols from acutely infected pigs  

Technology Transfer Automated Retrieval System (TEKTRAN)

Infectious agents that cause respiratory disease in pigs include porcine reproductive respiratory syndrome virus (PRRSV), porcine circovirus type 2 (PCV2), swine influenza virus (SIV), porcine respiratory corona virus (PRCV), Mycoplasma hyopneumoniae, and Bordetella bronchiseptica. The objective of...

362

Serial Analysis of the Gut and Respiratory Microbiome in Cystic Fibrosis in Infancy: Interaction between Intestinal and Respiratory Tracts and Impact of Nutritional Exposures  

PubMed Central

ABSTRACT Pulmonary damage caused by chronic colonization of the cystic fibrosis (CF) lung by microbial communities is the proximal cause of respiratory failure. While there has been an effort to document the microbiome of the CF lung in pediatric and adult patients, little is known regarding the developing microflora in infants. We examined the respiratory and intestinal microbiota development in infants with CF from birth to 21 months. Distinct genera dominated in the gut compared to those in the respiratory tract, yet some bacteria overlapped, demonstrating a core microbiota dominated by Veillonella and Streptococcus. Bacterial diversity increased significantly over time, with evidence of more rapidly acquired diversity in the respiratory tract. There was a high degree of concordance between the bacteria that were increasing or decreasing over time in both compartments; in particular, a significant proportion (14/16 genera) increasing in the gut were also increasing in the respiratory tract. For 7 genera, gut colonization presages their appearance in the respiratory tract. Clustering analysis of respiratory samples indicated profiles of bacteria associated with breast-feeding, and for gut samples, introduction of solid foods even after adjustment for the time at which the sample was collected. Furthermore, changes in diet also result in altered respiratory microflora, suggesting a link between nutrition and development of microbial communities in the respiratory tract. Our findings suggest that nutritional factors and gut colonization patterns are determinants of the microbial development of respiratory tract microbiota in infants with CF and present opportunities for early intervention in CF with altered dietary or probiotic strategies. PMID:22911969

Madan, J. C.; Koestler, D. C.; Stanton, B. A.; Davidson, L.; Moulton, L. A.; Housman, M. L.; Moore, J. H.; Guill, M. F.; Morrison, H. G.; Sogin, M. L.; Hampton, T. H.; Karagas, M. R.; Palumbo, P. E.; Foster, J. A.; Hibberd, P. L.; O’Toole, G. A.

2012-01-01

363

The Acute Respiratory Distress Syndrome  

NSDL National Science Digital Library

Physiology in Medicine review article. This review describes the clinical, etiologic, and physiologic basis of ARDS and summarizes our understanding of how its molecular pathogenesis leads to the physiologic alterations of respiratory failure, emphasizing factors known to be involved in the formation and resolution of permeability pulmonary edema. It also provides a physiologic basis for understanding and implementing modern strategies for the respiratory management of patients with ARDS.

Claude A. Piantadosi (Duke University Medical Center); David A. Schwartz (Duke University Medical Center)

2004-09-22

364

User's manual for MOCUS-BACKFIRE [i.e. MOCUS-BACFIRE] : a computer program for common cause failure analysis  

E-print Network

This report is the user's manual for MOCUS-BACFIRE, a computer programme for qualitative common cause analysis. The MOCUSBACFIRE package code was developed by coupling the MOCUS code and BACFIRE code. The MOCUS code is a ...

Heising, Carolyn D.

1981-01-01

365

Protection against soman-induced neuropathology and respiratory failure: a comparison of the efficacy of diazepam and avizafone in guinea pig.  

PubMed

The purpose of this study was to compare the efficacy of diazepam and the pro-diazepam avizafone in preventing the severity of soman-induced pathology in guinea pig. Survival, respiration and seizures of experimental animals were investigated with on-line monitoring of respiratory and EEG parameters. Guinea pigs were pretreated with pyridostigmine (0.1mg/kg i.m.) and 30 min later challenged with 1 or 2 LD50 soman. One minute after intoxication they were treated with atropine (3 or 33.8 mg/kg), pralidoxime chloride (32 mg/kg) and either diazepam (2 mg/kg), avizafone (3.5 mg/kg) or saline solution. The highest dose of atropine (33.8 mg/kg) gave a protective effect in groups treated without anticonvulsants by reducing the severity of clinical signs and death within 24 h but also by decreasing seizure occurrence and brain injuries. When injected at the similar molar dose of 7 micromoles/kg, the protection of anticonvulsants against soman neurotoxicity was higher with the atropine/pralidoxime/avizafone combination than with atropine/pralidoxime/diazepam. Indeed, when atropine was used at the lowest dose, avizafone was found to prevent early mortality and seizures occurrence with better efficacy than diazepam. On the other hand, when added to the therapy, the both anticonvulsants did not prevent the moderate EEG depression (reduction of amplitude by 30-52%) observed under 2 LD50 soman. Moreover, the number of animals suffering from respiratory distress (defined as a decrease of minute ventilation of more than 20% from the baseline value) was enhanced when diazepam or avizafone were used in the therapy. This effect was dependent on the atropine dose and the nature of the anticonvulsant. The beneficial effects of the different therapeutics tested were assessed and compared to the previous data obtained with the same therapies against sarin and from the pharmacokinetics properties of the atropine/diazepam mixture. PMID:16784801

Taysse, L; Daulon, S; Delamanche, S; Bellier, B; Breton, P

2006-08-01

366

Multiplex quantitative PCR for detection of lower respiratory tract infection and meningitis caused by Streptococcus pneumoniae, Haemophilus influenzae and Neisseria meningitidis  

PubMed Central

Background Streptococcus pneumoniae and Haemophilus influenzae cause pneumonia and as Neisseria meningitidis they are important agents of meningitis. Although several PCR methods have been described for these bacteria the specificity is an underestimated problem. Here we present a quantitative multiplex real-time PCR (qmPCR) for detection of S. pneumoniae (9802 gene fragment), H. influenzae (omp P6 gene) and N. meningitidis (ctrA gene). The method was evaluated on bronchoalveolar lavage (BAL) samples from 156 adults with lower respiratory tract infection (LRTI) and 31 controls, and on 87 cerebrospinal fluid (CSF) samples from meningitis patients. Results The analytical sensitivity was not affected by using a combined mixture of reagents and a combined DNA standard (S. pneumoniae/H. influenzae/N. meningitidis) in single tubes. By blood- and BAL-culture and S. pneumoniae urinary antigen test, S. pneumoniae and H. influenzae were aetiological agents in 21 and 31 of the LTRI patients, respectively. These pathogens were identified by qmPCR in 52 and 72 of the cases, respectively, yielding sensitivities and specificities of 95% and 75% for S. pneumoniae, and 90% and 65% for H. influenzae, respectively. When using a cut-off of 105 genome copies/mL for clinical positivity the sensitivities and specificities were 90% and 80% for S. pneumoniae, and 81% and 85% for H. influenzae, respectively. Of 44 culture negative but qmPCR positive for H. influenzae, 41 were confirmed by fucK PCR as H. influenzae. Of the 103 patients who had taken antibiotics prior to sampling, S. pneumoniae and H. influenzae were identified by culture in 6% and 20% of the cases, respectively, and by the qmPCR in 36% and 53% of the cases, respectively. In 87 CSF samples S. pneumoniae and N. meningitidis were identified by culture and/or 16 S rRNA in 14 and 10 samples and by qmPCR in 14 and 10 samples, respectively, giving a sensitivity of 100% and a specificity of 100% for both bacteria. Conclusions The PCR provides increased sensitivity and the multiplex format facilitates diagnosis of S. pneumoniae, H. influenzae and N. meningitidis and the assay enable detection after antibiotic treatment has been installed. Quantification increases the specificity of the etiology for pneumonia. PMID:21129171

2010-01-01

367

Respiratory syncytial virus infection in owl monkeys: viral shedding, immunological response, and associated illness caused by wild-type virus and two temperature-sensitive mutants.  

PubMed Central

Intranasal inoculation of owl monkeys with wild-type respiratory syncytial virus induced upper respiratory tract disease in each of seven animals. The response of owl monkeys to two highly defective, temperature-sensitive, multiple-lesion mutants was then compared to the pattern seen with wild-type respiratory syncytial virus. These mutants, ts-1 NG-1 and ts-1 NG-16, were derived from the ts-1 mutant that had been remutagenized with nitrosoguanidine (NG). Previously the ts-1 NG-1 and ts-1 NG-16 mutants had been shown to be more temperature sensitive and more stable genetically than their ts-1 parent. Both ts-1 NG-1 and ts-1 NG-16 produced infection that was delayed in onsent compared to wild-type virus infection. However, the mutants were shed from the upper respiratory tract for the same period of time and at the same titer as wild-type virus. The serum neutralizing antibody response to infection with the mutants was nearly equivalent to that elicited by wild-type virus. However, the extent of disease induced by the mutants was significantly less than that seen with wild-type virus. These observations suggest that the mutants are potential vaccine condidates and should be subjected to additional in vivo testing in primates and, ultimately, humans. PMID:118925

Prince, G A; Suffin, S C; Prevar, D A; Camargo, E; Sly, D L; London, W T; Chanock, R M

1979-01-01

368

A physically-based method for predicting peak discharge of floods caused by failure of natural and constructed earthen dams  

USGS Publications Warehouse

We analyse a simple, physically-based model of breach formation in natural and constructed earthen dams to elucidate the principal factors controlling the flood hydrograph at the breach. Formation of the breach, which is assumed trapezoidal in cross-section, is parameterized by the mean rate of downcutting, k, the value of which is constrained by observations. A dimensionless formulation of the model leads to the prediction that the breach hydrograph depends upon lake shape, the ratio r of breach width to depth, the side slope ?? of the breach, and the parameter ?? = (V.D3)(k/???gD), where V = lake volume, D = lake depth, and g is the acceleration due to gravity. Calculations show that peak discharge Qp depends weakly on lake shape r and ??, but strongly on ??, which is the product of a dimensionless lake volume and a dimensionless erosion rate. Qp(??) takes asymptotically distinct forms depending on whether < ??? 1 or < ??? 1. Theoretical predictions agree well with data from dam failures for which k could be reasonably estimated. The analysis provides a rapid and in many cases graphical way to estimate plausible values of Qp at the breach.We analyze a simple, physically-based model of breach formation in natural and constructed earthen dams to elucidate the principal factors controlling the flood hydrograph at the breach. Formation of the breach, which is assumed trapezoidal in cross-section, is parameterized by the mean rate of downcutting, k, the value of which is constrained by observations. A dimensionless formulation of the model leads to the prediction that the breach hydrograph depends upon lake shape, the ratio r of breach width to depth, the side slope ?? of the breach, and the parameter ?? = (V/D3)(k/???gD), where V = lake volume, D = lake depth, and g is the acceleration due to gravity. Calculations show that peak discharge Qp depends weakly on lake shape r and ??, but strongly on ??, which is the product of a dimensionless lake volume and a dimensionless erosion rate. Qp(??) takes asymptotically distinct forms depending on whether ?????1 or ?????1. Theoretical predictions agree well with data from dam failures for which k could be reasonably estimated. The analysis provides a rapid and in many cases graphical way to estimate plausible values of Qp at the breach.

Walder, J.S.; O'Connor, J. E.; Costa, J.E.

1997-01-01

369

Application of Failure Mode and Effect Analysis (FMEA) and cause and effect analysis in conjunction with ISO 22000 to a snails (Helix aspersa) processing plant; A case study.  

PubMed

Failure Mode and Effect Analysis (FMEA) has been applied for the risk assessment of snails manufacturing. A tentative approach of FMEA application to the snails industry was attempted in conjunction with ISO 22000. Preliminary Hazard Analysis was used to analyze and predict the occurring failure modes in a food chain system (snails processing plant), based on the functions, characteristics, and/or interactions of the ingredients or the processes, upon which the system depends. Critical Control points have been identified and implemented in the cause and effect diagram (also known as Ishikawa, tree diagram, and fishbone diagram). In this work a comparison of ISO22000 analysis with HACCP is carried out over snails processing and packaging. However, the main emphasis was put on the quantification of risk assessment by determining the RPN per identified processing hazard. Sterilization of tins, bioaccumulation of heavy metals, packaging of shells and poisonous mushrooms, were the processes identified as the ones with the highest RPN (280, 240, 147, 144, respectively) and corrective actions were undertaken. Following the application of corrective actions, a second calculation of RPN values was carried out leading to considerably lower values (below the upper acceptable limit of 130). It is noteworthy that the application of Ishikawa (Cause and Effect or Tree diagram) led to converging results thus corroborating the validity of conclusions derived from risk assessment and FMEA. Therefore, the incorporation of FMEA analysis within the ISO22000 system of a snails processing industry is considered imperative. PMID:19582641

Arvanitoyannis, Ioannis S; Varzakas, Theodoros H

2009-08-01

370

Application of ISO22000, failure mode, and effect analysis (FMEA) cause and effect diagrams and pareto in conjunction with HACCP and risk assessment for processing of pastry products.  

PubMed

The Failure Mode and Effect Analysis (FMEA) model has been applied for the risk assessment of pastry processing. A tentative approach of FMEA application to the pastry industry was attempted in conjunction with ISO22000. Preliminary Hazard Analysis was used to analyze and predict the occurring failure modes in a food chain system (pastry processing plant), based on the functions, characteristics, and/or interactions of the ingredients or the processes, upon which the system depends. Critical Control points have been identified and implemented in the cause and effect diagram (also known as Ishikawa, tree diagram, and fishbone diagram). In this work a comparison of ISO22000 analysis with HACCP is carried out over pastry processing and packaging. However, the main emphasis was put on the quantification of risk assessment by determining the Risk Priority Number (RPN) per identified processing hazard. Storage of raw materials and storage of final products at -18°C followed by freezing were the processes identified as the ones with the highest RPN (225, 225, and 144 respectively) and corrective actions were undertaken. Following the application of corrective actions, a second calculation of RPN values was carried out leading to considerably lower values (below the upper acceptable limit of 130). It is noteworthy that the application of Ishikawa (Cause and Effect or Tree diagram) led to converging results thus corroborating the validity of conclusions derived from risk assessment and FMEA. Therefore, the incorporation of FMEA analysis within the ISO22000 system of a pastry processing industry is considered imperative. PMID:21838557

Varzakas, Theodoros H

2011-09-01

371

A physically-based method for predicting peak discharge of floods caused by failure of natural and constructed earthen dams  

USGS Publications Warehouse

We analyse a simple, physically-based model of breach formation in natural and constructed earthen dams to elucidate the principal factors controlling the flood hydrograph at the breach. Formation of the breach, which is assumed trapezoidal in cross-section, is parameterized by the mean rate of downcutting, k, the value of which is constrained by observations. A dimensionless formulation of the model leads to the prediction that the breach hydrograph depends upon lake shape, the ratio r of breach width to depth, the side slope ?? of the breach, and the parameter ?? = (V/ D3)(k/???gD), where V = lake volume, D = lake depth, and g is the acceleration due to gravity. Calculations show that peak discharge Qp depends weakly on lake shape r and ??, but strongly on ??, which is the product of a dimensionless lake volume and a dimensionless erosion rate. Qp(??) takes asymptotically distinct forms depending on whether ?? > 1. Theoretical predictions agree well with data from dam failures for which k could be reasonably estimated. The analysis provides a rapid and in many cases graphical way to estimate plausible values of Qp at the breach.

Walder, J.S.

1997-01-01

372

Review article Porcine respiratory coronavirus  

E-print Network

Review article Porcine respiratory coronavirus: molecular features and virus-host interactions H respiratory coronavirus, causing a mostly un- apparent infection, has rapidly and massively spread within identified in the USA. The agent, designated PRCV, appears to be derived from the porcine enteric coronavirus

Paris-Sud XI, Université de

373

Fulminant community-acquired pneumonia probably caused by Acinetobacter lwoffii.  

PubMed

We describe a case of fulminant community-acquired pneumonia probably caused by Acinetobacter lwoffii. A 63-year-old woman was admitted with an acute respiratory illness and consolidation in the right upper lobe. She deteriorated rapidly despite antibiotic therapy, and required ventilatory support. The patient died of multiple organ failure and intractable shock, 7 days after admission to hospital; her disease was probably caused by A. lwoffii. PMID:20546186

Toyoshima, Mikio; Chida, Kingo; Suda, Takafumi

2010-07-01

374

Failure to downregulate the epithelial sodium channel causes salt sensitivity in Hsd11b2 heterozygote mice.  

PubMed

In vivo, the enzyme 11?-hydroxysteroid dehydrogenase type 2 influences ligand access to the mineralocorticoid receptor. Ablation of the encoding gene, HSD11B2, causes the hypertensive syndrome of apparent mineralocorticoid excess. Studies in humans and experimental animals have linked reduced 11?-hydroxysteroid dehydrogenase type 2 activity and salt sensitivity of blood pressure. In the present study, renal mechanisms underpinning salt sensitivity were investigated in Hsd11b2(+/-) mice fed low-, standard-, and high-sodium diets. In wild-type mice, there was a strong correlation between dietary sodium content and fractional sodium excretion but not blood pressure. High sodium feeding abolished amiloride-sensitive sodium reabsorption, consistent with downregulation of the epithelial sodium channel. In Hsd11b2(+/-) mice, the natriuretic response to increased dietary sodium content was blunted, and epithelial sodium channel activity persisted. High-sodium diet also reduced renal blood flow and increased blood pressure in Hsd11b2(+/-) mice. Aldosterone was modulated by dietary sodium in both genotypes, and salt sensitivity in Hsd11b2(+/-) mice was associated with increased plasma corticosterone levels. Chronic administration of an epithelial sodium channel blocker or a glucocorticoid receptor antagonist prevented salt sensitivity in Hsd11b2(+/-) mice, whereas mineralocorticoid receptor blockade with spironolactone did not. This study shows that reduced 11?-hydroxysteroid dehydrogenase type 2 causes salt sensitivity of blood pressure because of impaired renal natriuretic capacity. This reflects deregulation of epithelial sodium channels and increased renal vascular resistance. The phenotype is not caused by illicit activation of mineralocorticoid receptors by glucocorticoids but by direct activation of glucocorticoid receptors. PMID:22777941

Craigie, Eilidh; Evans, Louise C; Mullins, John J; Bailey, Matthew A

2012-09-01

375

Applied respiratory physiology  

Microsoft Academic Search

Anaesthesia has many effects on respiratory physiology, the knowledge of which is relevant to clinical practice. Anaesthesia causes decreased muscle tone in the upper airway, which can lead to airway obstruction. Pulmonary hypoventilation occurs in the spontaneously breathing patient. There is a progressive decrease in the ventilatory response to CO2 with increasing concentration of volatile agents, and even low doses

Derek Randles; Stuart Dabner

2011-01-01

376

Applied respiratory physiology  

Microsoft Academic Search

Anaesthesia has many effects on respiratory physiology, the knowledge of which is relevant to clinical practice. Anaesthesia causes decreased muscle tone in the upper airway, which can lead to airway obstruction. Pulmonary hypoventilation occurs in the spontaneously breathing patient. There is a progressive decrease in the ventilatory response to CO2 with increasing concentration of volatile agents, and even low doses

Derek Randles; Stuart Dabner

2008-01-01

377

Respiratory function after selective respiratory motor neuron death from intrapleural CTB-saporin injections.  

PubMed

Amyotrophic lateral sclerosis (ALS) causes progressive motor neuron degeneration, paralysis and death by ventilatory failure. In rodent ALS models: 1) breathing capacity is preserved until late in disease progression despite major respiratory motor neuron death, suggesting unknown forms of compensatory respiratory plasticity; and 2) spinal microglia become activated in association with motor neuron cell death. Here, we report a novel experimental model to study the impact of respiratory motor neuron death on compensatory responses without many complications attendant to spontaneous motor neuron disease. In specific, we used intrapleural injections of cholera toxin B fragment conjugated to saporin (CTB-SAP) to selectively kill motor neurons with access to the pleural space. Motor neuron survival, CD11b labeling (microglia), ventilatory capacity and phrenic motor output were assessed in rats 3-28days after intrapleural injections of: 1) CTB-SAP (25 and 50?g), or 2) unconjugated CTB and SAP (i.e. control; (CTB+SAP). CTB-SAP elicited dose-dependent phrenic and intercostal motor neuron death; 7days post-25?g CTB-SAP, motor neuron survival approximated that in end-stage ALS rats (phrenic: 36±7%; intercostal: 56±10% of controls; n=9; p<0.05). CTB-SAP caused minimal cell death in other brainstem or spinal cord regions. PMID:25476493

Nichols, Nicole L; Vinit, Stéphane; Bauernschmidt, Lorene; Mitchell, Gordon S

2014-12-01

378

Original article Bovine respiratory syncytial virus  

E-print Network

Original article Bovine respiratory syncytial virus: first serological evidence in Uruguay Mauro; accepted 18 November 1999) Abstract ­ Bovine respiratory syncytial virus (BRSV) is a major cause of respiratory disease in calves resulting in a substantial economic loss for the cattle industry worldwide

Boyer, Edmond

379

CADMIUM AS A RESPIRATORY TOXICANT  

EPA Science Inventory

Cadmium is a major respiratory toxicant as evidenced by numerous human and animal studies. Controlled animal inhalation studies provide supporting evidence to the associations observed in epidemiological studies that Cd has the potential to cause lung fibrosis, emphysema, cancer,...

380

Middle East Respiratory Syndrome (MERS)  

MedlinePLUS

... MERS) is viral respiratory illness first reported in Saudi Arabia in 2012. It is caused by a coronavirus ... of MERS was confirmed in a traveler from Saudi Arabia to the U.S. On May 11, 2014, a ...

381

Trends in survival from muscular dystrophy in England and Wales and impact on respiratory services.  

PubMed

Respiratory failure is an important terminal event in muscular dystrophy, but increasingly is effectively treated by non-invasive ventilation. This study was designed to assess mortality statistics in this patient group in order to get an indication of future demand. Mortality data for all deaths from muscular dystrophy registered by death certification in England and Wales between 1993 and 1999 were analysed. In total, 817 deaths from muscular dystrophy were registered between 1993 and 1999. Annual number of deaths was unchanged over this period. Median age at death (interquartile range) for all cause muscular dystrophy increased from 20 (17-42.5) years in 1993, to 26 (17.5-63) years in 1999. Respiratory failure was the primary or contributory cause of death in 82% of cases. Two thirds of these deaths were during acute infection. We can expect 100 patients with muscular dystrophy to develop respiratory failure in England and Wales each year, so non-invasive ventilation services probably need to be able to provide for 0.2 new patients per 100,000 population annually. Respiratory services also need to provide adequate monitoring and early treatment of infection in these patients. PMID:16257521

Calvert, L D; McKeever, T M; Kinnear, W J M; Britton, J R

2006-06-01

382

Short term haemodynamic effects of converting enzyme inhibition before and after eating in patients with moderate heart failure caused by dilated cardiomyopathy: a double blind study.  

PubMed Central

The haemodynamic changes that follow a meal can mimic the response to a vasodilator drug. To avoid overestimating the beneficial effects of treatment in uncontrolled studies, measurements of haemodynamic function are usually performed with patients in the fasting postabsorptive state. But such recordings are not representative of the resting patient during daily life. In this double blind placebo controlled study the short term haemodynamic effects of enalapril were assessed during 12 hours in 19 patients with moderate heart failure caused by dilated cardiomyopathy. The patients ate lunch and dinner and were studied in the absorptive and postabsorptive phases. In the placebo group systemic vascular resistance, mean arterial pressure, and the rate-pressure product fell significantly (5-16%) after lunch. Four hours after lunch the haemodynamic function had returned to baseline--that is the postabsorptive state. Enalapril, accentuated the haemodynamic effects during the absorptive state producing a larger post-prandial fall in mean arterial blood pressure and rate-pressure product and changes in the absorptive phase were maintained into the post-absorptive phase. Pulmonary wedge pressure fell significantly after treatment with enalapril. These overall changes during the study period indicated that enalapril reduced the preload and afterload on the heart--over and above the reduction produced by eating. These findings suggest that the effects of enalapril given at rest to patients with moderate heart failure unload the heart and enhance the reduction of afterload induced by meals. PMID:2178657

Herrlin, B; Sylvén, C; Nyquist, O; Edhag, O

1990-01-01

383

Could millisecond timing errors in commonly used equipment be a cause of replication failure in some neuroscience studies?  

PubMed

Neuroscience is a rapidly expanding field in which complex studies and equipment setups are the norm. Often these push boundaries in terms of what technology can offer, and increasingly they make use of a wide range of stimulus materials and interconnected equipment (e.g., magnetic resonance imaging, electroencephalography, magnetoencephalography, eyetrackers, biofeedback, etc.). The software that bonds the various constituent parts together itself allows for ever more elaborate investigations to be carried out with apparent ease. However, research over the last decade has suggested a growing, yet underacknowledged, problem with obtaining millisecond-accurate timing in some computer-based studies. Crucially, timing inaccuracies can affect not just response time measurements, but also stimulus presentation and the synchronization between equipment. This is not a new problem, but rather one that researchers may have assumed had been solved with the advent of faster computers, state-of-the-art equipment, and more advanced software. In this article, we highlight the potential sources of error, their causes, and their likely impact on replication. Unfortunately, in many applications, inaccurate timing is not easily resolved by utilizing ever-faster computers, newer equipment, or post-hoc statistical manipulation. To ensure consistency across the field, we advocate that researchers self-validate the timing accuracy of their own equipment whilst running the actual paradigm in situ. PMID:23640111

Plant, Richard R; Quinlan, Philip T

2013-09-01

384

A 1.1-Mb Segmental Deletion on the X Chromosome Causes Meiotic Failure in Male Mice1  

PubMed Central

ABSTRACT The mammalian X chromosome contains a large number of multicopy genes that are expressed during spermatogenesis. The roles of these genes during germ cell development and the functional significance of gene multiplication remain mostly unexplored, as the presence of multicopy gene families poses a challenge for genetic studies. Here we report the deletion of a 1.1-Mb segment of the mouse X chromosome that is syntenic with the human Xq22.1 region and contains 20 genes that are expressed predominantly in testis and brain, including three members of the nuclear export factor gene family (Nxf2, Nxf3, and Nxf7) and five copies of preferentially expressed antigen in melanoma-like 3 (Pramel3). We have shown that germline-specific Cre/loxP-mediated deletion of this 1.1-Mb segment is efficient and causes defective chromosomal synapsis, meiotic arrest, and sterility in male mice. Our results demonstrate that this 1.1-Mb region contains one or more novel X-linked factors that are essential for male meiosis. PMID:23677977

Zhou, Jian; McCarrey, John R.; Wang, P. Jeremy

2013-01-01

385

Heart Failure  

MedlinePLUS

... of breath Common causes of heart failure are coronary artery disease, high blood pressure and diabetes. It is more common in people who are 65 years old or older, African Americans, people who are ... treatments fail. NIH: National Heart, Lung, and Blood Institute

386

CNV resolution does not cause NoGo anteriorisation of the P3: a failure to replicate Simson et al.  

PubMed

For 35 years, some researchers have argued that CNV resolution may affect or even produce the increased P3 for NoGo compared to Go trials, and thus that no 'inhibitory' NoGo P3 exists. This is based on the work of Simson et al. (1977b), the scalp topography of potentials in auditory and visual Go/NoGo tasks. Electroencephalography and Clinical Neurophysiology, 43, 864-875, which compared Go and NoGo topography after CNV was subtracted from NoGo trials only. Specifically, the NoGo P3 topography showed the distinctive frontocentral maximum, which is often linked to motor inhibition, when referenced to a pre-target baseline. This NoGo topography changed to a more parietal maximum, similar to that on Go trials, when referenced to a pre-cue baseline. Many researchers have cited this study, while failing to use the delayed response design on which Simson et al. based their argument. We attempted to replicate Simson et al.'s experiment with delayed responses and also with immediate responses, as are more often used. As expected, the amplitudes of CNV and P3 to both Go and NoGo trials were increased when immediate compared to delayed responses were required, but we failed to replicate the topographic shift of NoGo P3 with different baselines for both delayed and immediate responses. That is, subtraction of the CNV from NoGo P3 did not change the distinctive frontocentral topography of this component. The results suggest that CNV may affect the amplitude and measurement of the NoGo P3, but that NoGo P3 anteriorisation is not caused by CNV resolution. PMID:23669175

Smith, Janette L; Barry, Robert J; Steiner, Genevieve Z

2013-09-01

387

Otalgia and eschar in the external auditory canal in scrub typhus complicated by acute respiratory distress syndrome and multiple organ failure  

Microsoft Academic Search

Background  Scrub typhus, a mite-transmitted zoonosis caused by Orientia tsutsugamushi, is an endemic disease in Taiwan and may be potentially fatal if diagnosis is delayed.\\u000a \\u000a \\u000a \\u000a \\u000a Case presentations  We encountered a 23-year-old previously healthy Taiwanese male soldier presenting with the right ear pain after training in\\u000a the jungle and an eleven-day history of intermittent high fever up to 39°C. Amoxicillin\\/clavulanate was prescribed for

Bor-Jen Lee; Chia-Yi Chen; Sung-Yuan Hu; Yu-Tse Tsan; Tzu-Chieh Lin; Lee-Min Wang

2011-01-01

388

Acute respiratory distress syndrome in a pregnant woman with systemic lupus erythematosus: a case report.  

PubMed

When the disease activity of systemic lupus erythematosus (SLE) is controlled appropriately, a pregnant woman who has lupus is able to carry safely to term and deliver a healthy infant. While the physiology of a healthy pregnancy itself influences ventilatory function, acute pulmonary distress may decrease oxygenation and influence both mother and fetus. Though respiratory failure in pregnancy is relatively rare, it remains one of the leading conditions requiring intensive care unit admission in pregnancy and carries a high risk of maternal and fetal morbidity and mortality, not to mention the complexity caused by lupus flare. We report a case of SLE complicated with lupus pneumonitis and followed by acute respiratory distress during pregnancy. Though there is a high risk of maternal and fetal morbidity and mortality, maternal respiratory function improved after cesarean section and treatment of the underlying causes. The newborn had an extremely low birth weight but was well at discharge. PMID:25145338

Chen, Y-J A; Tseng, J-J; Yang, M-J; Tsao, Y-P; Lin, H-Y

2014-12-01

389

Use of heliox delivered via high-flow nasal cannula to treat an infant with coronavirus-related respiratory infection and severe acute air-flow obstruction.  

PubMed

Heliox, a helium-oxygen gas mixture, has been used for many decades to treat obstructive pulmonary disease. The lower density and higher viscosity of heliox relative to nitrogen-oxygen mixtures can significantly reduce airway resistance when an anatomic upper air-flow obstruction is present and gas flow is turbulent. Clinically, heliox can decrease airway resistance in acute asthma in adults and children and in COPD. Heliox may also enhance the bronchodilating effects of ?-agonist administration for acute asthma. Respiratory syndromes caused by coronavirus infections in humans range in severity from the common cold to severe acute respiratory syndrome associated with human coronavirus OC43 and other viral strains. In infants, coronavirus infection can cause bronchitis, bronchiolitis, and pneumonia in variable combinations and can produce enough air-flow obstruction to cause respiratory failure. We describe a case of coronavirus OC43 infection in an infant with severe acute respiratory distress treated with heliox inhalation to avoid intubation. PMID:25118308

Morgan, Sherwin E; Vukin, Kirissa; Mosakowski, Steve; Solano, Patti; Stanton, Lolita; Lester, Lucille; Lavani, Romeen; Hall, Jesse B; Tung, Avery

2014-11-01

390

Elevated luteal phase estradiol:progesterone ratio in mice causes implantation failure by creating a uterine environment that suppresses embryonic metabolism.  

PubMed

Failure of implantation after in vitro fertilization is sometimes associated with elevated estradiol (E2):progesterone (P) ratios in the early luteal phase. Using the mouse to study the causes of the contragestational actions of elevated E2:P ratios, it was confirmed that administration of E2 (40 to 80 ng) before implantation inhibited implantation and 0.4 mg of P totally reversed the effect of 40 ng E2. Fluids collected from the uterine lumen of E2-treated (40 ng) mice significantly inhibited the incorporation of 3H-uridine by mouse blastocysts in vitro, whereas fluids from mice treated with E2 (40 ng) and P (0.4 mg) together had no inhibitory effect. In contrast to these contraceptive effects of high E2, lower levels of E2 (5 and 20 ng) caused an increase and no change to the implantation rate, respectively, and fluids from mice treated with E2 (20 ng) significantly enhanced blastocyst metabolism. Concomitant administration of P to these low dose E2 mice enhanced these effects. Thus, a large elevation of the E2:P ratio inhibited implantation and created a uterine lumenal milieu that suppressed embryonic metabolism. These effects could be reversed and implantation re-established by the correction of the E2:P ratio by exogenous P. PMID:2245842

Safro, E; O'Neill, C; Saunders, D M

1990-12-01

391

[Development and validation of the real-time PCR assay for the identification of viral agents causing acute respiratory infections in humans].  

PubMed

The real time PCR assay targeting influenza A and B virus, 5 subtypes of influenza A virus (seasonal H1N1, pandemic H1N1 (2009), seasonal H3N2, pathogenic for human subtypes of avian influenza H5 and H7), respiratory syncytial virus, and adenovirus was developed. The analytical sensitivity of the developed assay was 1 x 10(3) genome equivalents per ml. The diagnostic sensitivity of the method was 1 x l0(3)-10(4) viral particles per ml. Experiments with human DNA/cDNA and viral cDNA showed a markedly high diagnostic specificity of the developed PCR assay. In the assay of the developed PCR test, 50 nasopharyngeal swab specimens were tested. The etiology was identified in 33 samples. PMID:24645276

Sergeeva, E I; Ternovo?, V A; Demina, O K; Demina, A V; Korneev, A N; Shikov, A N; Berillo, S A; Agafonov, A P; Sergeev, A N

2013-01-01

392

Evaluation of efficacy of non-invasive ventilation in Non-COPD and non-trauma patients with acute hypoxemic respiratory failure: A systematic review and meta-analysis  

PubMed Central

Non-invasive ventilation (NIV) has been widely supported in the past two decades as an effective application in avoiding the need for endotracheal intubation (ETI) and reducing associated mortality in acute hypoxemic respiratory failure (AHRF) patients. However, the efficacy of NIV in AHRF patients, non-related to chronic obstructive pulmonary disease (COPD) and trauma is still controversial in the field of medical research. This retrospective study aimed to evaluate the efficacy of NIV as an adjunctive therapy in non-COPD and non-traumatic AHRF patients. Data of 11 randomized control trials (RCTs), which were conducted between 1990 and 2010 to determine the efficacy of NIV in non-COPD and non-traumatic AHRF patients, were reviewed from the PUBMED, MEDLINE, Cochrane Library, and EMBASE databases. Parameters monitored in this study included the ETI rate, fatal complications, mortality rate of patients, and their ICU and hospital duration of stay. Overall results showed a statistically significant decrease in the rate of ETI, mortality, and fatal complications along with reduced ICU and hospital length of stay in non-COPD and non-trauma AHRF patients of various etiologies. This systematic review suggests that non-COPD and non-trauma AHRF patients can potentially benefit from NIV as compared with conventional treatment methods. Observations from various cohort studies, observational studies, and previously published literature advocate on the efficacy of NIV for treating non-COPD and non-traumatic AHRF patients. However, considering the diversity of studied populations, further studies and more specific trials on less heterogeneous AHRF patient groups are needed to focus on this aspect. PMID:25593602

AlYami, Marja A.; AlAhmari, Mohammed D.; Alotaibi, Hajed; AlRabeeah, Saad; AlBalawi, Ibrahim; Mubasher, Mohamed

2015-01-01

393

Kidney Failure  

MedlinePLUS

... Details» www.kidneyfund.org > Kidney Disease > Kidney Failure Kidney Failure Kidney failure is when your kidneys stop ... are the tests for kidney failure? How is kidney failure (ESRD) different from chronic kidney disease (CKD)? ...

394

Cause of Flu (Influenza)  

MedlinePLUS

... in humans and many animals, including ducks, chickens, pigs, and whales. Type A influenza viruses caused the ... humans. Type C viruses are found in humans, pigs, and dogs and cause mild respiratory infections but ...

395

Corynebacterium pseudodiphtheriticum: a respiratory tract pathogen in adults.  

PubMed

Corynebacterium pseudodiphtheriticum has been reported to be an uncommon respiratory pathogen. We describe the clinical and microbiologic features of 17 patients from whose sputum C. pseudodiphtheriticum was isolated. Patients were identified through a review of the reports from the clinical microbiology laboratory at York Hospital, a community teaching hospital, from October 1990 through April 1993; 17 patients with respiratory infection caused by C. pseudodiphthriticum were identified. There were 12 cases of bronchitis and five of pneumonia. An underlying systemic condition, particularly congestive heart failure, chronic obstructive pulmonary disease, diabetes mellitus, or malignancy, was common. Onset of symptomatology was acute for most patients, but fever was noticeably absent in almost two-thirds of the cases. Isolates were uniformly susceptible to the beta-lactam antibiotics, vancomycin, and trimethoprim-sulfamethoxazole, but resistance to clindamycin and erythromycin was common. The isolation of diphtheroids from a properly obtained sputum sample from a patient with respiratory tract infection should not always be dismissed as due to contamination. The isolation, identification, and susceptibility testing of C. pseudodiphtheriticum from respiratory tract specimens may provide information useful for treatment of patients. PMID:7727667

Manzella, J P; Kellogg, J A; Parsey, K S

1995-01-01

396

Immunogenetic Factors Associated with Severe Respiratory Illness Caused by Zoonotic H1N1 and H5N1 Influenza Viruses  

PubMed Central

Following the 2009 H1N1 pandemic and ongoing sporadic avian-to-human transmission of H5N1 viruses, an emphasis has been placed on better understanding the determinants and pathogenesis of severe influenza infections. Much of the current literature has focused on viral genetics and its impact on host immunity as well as novel risk factors for severe infection (particularly within the H1N1 pandemic). An understanding of the host genetic determinants of susceptibility and severe respiratory illness, however, is currently lacking. By better defining the role of genetic variability in influenza infection and identifying key polymorphisms that impair the host immune response or correlate with protection, we will be able to better identify at-risk populations and new targets for therapeutic interventions and vaccines. This paper will summarize known immunogenetic factors associated with susceptibility or severity of both pH1N1 and H5N1 infections and will also identify genetic pathways and polymorphisms of high relevance for future study. PMID:22110538

Juno, Jennifer; Fowke, Keith R.; Keynan, Yoav

2012-01-01

397

Integrated DNA and RNA extraction and purification on an automated microfluidic cassette from bacterial and viral pathogens causing community-acquired lower respiratory tract infections.  

PubMed

In this paper, we describe the development of an automated sample preparation procedure for etiological agents of community-acquired lower respiratory tract infections (CA-LRTI). The consecutive assay steps, including sample re-suspension, pre-treatment, lysis, nucleic acid purification, and concentration, were integrated into a microfluidic lab-on-a-chip (LOC) cassette that is operated hands-free by a demonstrator setup, providing fluidic and valve actuation. The performance of the assay was evaluated on viral and Gram-positive and Gram-negative bacterial broth cultures previously sampled using a nasopharyngeal swab. Sample preparation on the microfluidic cassette resulted in higher or similar concentrations of pure bacterial DNA or viral RNA compared to manual benchtop experiments. The miniaturization and integration of the complete sample preparation procedure, to extract purified nucleic acids from real samples of CA-LRTI pathogens to, and above, lab quality and efficiency, represent important steps towards its application in a point-of-care test (POCT) for rapid diagnosis of CA-LRTI. PMID:24615272

Van Heirstraeten, Liesbet; Spang, Peter; Schwind, Carmen; Drese, Klaus S; Ritzi-Lehnert, Marion; Nieto, Benjamin; Camps, Marta; Landgraf, Bryan; Guasch, Francesc; Corbera, Antoni Homs; Samitier, Josep; Goossens, Herman; Malhotra-Kumar, Surbhi; Roeser, Tina

2014-05-01

398

The role of polymorphisms in host immune genes in determining the severity of respiratory illness caused by pandemic H1N1 influenza.  

PubMed

Following the influenza epidemics, it has become clear that severity of illness is not uniform. Comorbidities and immunocompromise account for only a fraction of severe cases and do not explain the differential severity among the otherwise healthy during pandemics. During the 2009 H1N1 pandemic, a focus has been placed on better understanding of the determinants and pathogenesis of severe influenza infections. Much of the current literature has focused on viral genetics and its impact on host immunity as well as novel risk factors for severe infection (particularly within the H1N1 pandemic). The improved understanding of the cellular mechanisms and pathways involved in the pathogenesis of severe disease along with technological advances have allowed a more systematic approach to the exploration of the host genetic determinants of susceptibility and severe respiratory illness. By better defining the role of genetic variability in the immune responses to influenza, and identifying key polymorphisms that either protect against severe manifestation or those that impair the host immune response, it is possible to envision better methods to identify at-risk populations and new targets for therapeutic interventions and vaccines. This review will summarize the accumulated literature examining the immunogenetic factors associated with propensity for the development of severe pandemic H1N1 (pH1N1) manifestations. We will focus on novel and key insights gained through study of ethnic populations that appeared more vulnerable to severe disease during the 2009 H1N1 pandemic. PMID:23548712

Keynan, Y; Malik, S; Fowke, K R

2013-01-01

399

A Single Crossing-Over Event in Voltage-Sensitive Na+ Channel Genes May Cause Critical Failure of Dengue Mosquito Control by Insecticides  

PubMed Central

The voltage-sensitive sodium (Na+) channel (Vssc) is the target site of pyrethroid insecticides. Pest insects develop resistance to this class of insecticide by acquisition of one or multiple amino acid substitution(s) in this channel. In Southeast Asia, two major Vssc types confer pyrethroid resistance in the dengue mosquito vector Aedes aegypti, namely, S989P+V1016G and F1534C. We expressed several types of Vssc in Xenopus oocytes and examined the effect of amino acid substitutions in Vssc on pyrethroid susceptibilities. S989P+V1016G and F1534C haplotypes reduced the channel sensitivity to permethrin by 100- and 25-fold, respectively, while S989P+V1016G+F1534C triple mutations reduced the channel sensitivity to permethrin by 1100-fold. S989P+V1016G and F1534C haplotypes reduced the channel sensitivity to deltamethrin by 10- and 1-fold (no reduction), respectively, but S989P+V1016G+F1534C triple mutations reduced the channel sensitivity to deltamethrin by 90-fold. These results imply that pyrethroid insecticides are highly likely to lose their effectiveness against A. aegypti if such a Vssc haplotype emerges as the result of a single crossing-over event; thus, this may cause failure to control this key mosquito vector. Here, we strongly emphasize the importance of monitoring the occurrence of triple mutations in Vssc in the field population of A. aegypti. PMID:25166902

Hirata, Koichi; Komagata, Osamu; Itokawa, Kentaro; Yamamoto, Atsushi; Tomita, Takashi; Kasai, Shinji

2014-01-01

400

Infertility Associated with Meiotic Failure in the tremor Rat (tm/tm) is Caused by the Deletion of Spermatogenesis Associated 22  

PubMed Central

The tremor rat is an autosomal recessive mutant exhibiting sterility with gonadal hypoplasia in both sexes. The causative mutation tremor (tm) is known as a genomic deletion spanning >200 kb in Chr 10q24. Spermatogenesis associated 22 (Spata22) has been shown to be a vertebrate-specific gene essential for the progression of meiosis through prophase I and completion of chromosome synapsis and meiotic recombination using a mouse repro42 mutant carrying an N-ethyl-N-nitrosourea (ENU)-induced nonsense mutation in Spata22. In this study, we show that Spata22 was identified as the gene responsible for the failure of gametogenesis to progress beyond meiosis I in tm homozygous rats by a transgenic rescue experiment. Meiosis was arrested during prophase I in the mutant testis. Precise mapping of the breakage point revealed that the deleted genomic region spanned approximately 240 kb and comprised at least 13 genes, including Spata22. Rat Spata22 was predominantly expressed in the testis, and its transcription increased with the first wave of spermatogenesis, as seen in the mouse ortholog. These results suggest that Spata22 may play an important role in meiotic prophase I in rats, as seen in mice, and that the tm homozygous rat may be useful for investigating the physiological function of Spata22, as an experimental system for clarifying the effect of a null mutation, and may be an animal model for studying the pathogenesis and treatment of infertility caused by impaired meiosis. PMID:23903057

Ishishita, Satoshi; Inui, Toshihide; Matsuda, Yoichi; Serikawa, Tadao; Kitada, Kazuhiro

2013-01-01

401

A single crossing-over event in voltage-sensitive Na+ channel genes may cause critical failure of dengue mosquito control by insecticides.  

PubMed

The voltage-sensitive sodium (Na+) channel (Vssc) is the target site of pyrethroid insecticides. Pest insects develop resistance to this class of insecticide by acquisition of one or multiple amino acid substitution(s) in this channel. In Southeast Asia, two major Vssc types confer pyrethroid resistance in the dengue mosquito vector Aedes aegypti, namely, S989P+V1016G and F1534C. We expressed several types of Vssc in Xenopus oocytes and examined the effect of amino acid substitutions in Vssc on pyrethroid susceptibilities. S989P+V1016G and F1534C haplotypes reduced the channel sensitivity to permethrin by 100- and 25-fold, respectively, while S989P+V1016G+F1534C triple mutations reduced the channel sensitivity to permethrin by 1100-fold. S989P+V1016G and F1534C haplotypes reduced the channel sensitivity to deltamethrin by 10- and 1-fold (no reduction), respectively, but S989P+V1016G+F1534C triple mutations reduced the channel sensitivity to deltamethrin by 90-fold. These results imply that pyrethroid insecticides are highly likely to lose their effectiveness against A. aegypti if such a Vssc haplotype emerges as the result of a single crossing-over event; thus, this may cause failure to control this key mosquito vector. Here, we strongly emphasize the importance of monitoring the occurrence of triple mutations in Vssc in the field population of A. aegypti. PMID:25166902

Hirata, Koichi; Komagata, Osamu; Itokawa, Kentaro; Yamamoto, Atsushi; Tomita, Takashi; Kasai, Shinji

2014-08-01

402

Duality of the S–N fatigue curve caused by competing failure modes in a titanium alloy and the role of Poisson defect statistics  

Microsoft Academic Search

The mechanism of the duality of the S–N fatigue data (S is stress and N is cycles to failure) or the grouping of data into two distinct S–N curves as a result of two competing failure modes, occurring during fatigue of some ?+? microstructures of the metastable beta-titanium alloy Ti–10V–2Fe–3Al, is quantitatively assessed in this research. The competing failure modes

K. S. Ravi Chandran; S. K. Jha

2005-01-01

403

Respiratory Distress  

NASA Technical Reports Server (NTRS)

The University of Miami School of Medicine asked the Research Triangle Institute for assistance in improvising the negative pressure technique to relieve respiratory distress in infants. Marshall Space Flight Center and Johnson Space Center engineers adapted this idea to the lower-body negative-pressure system seals used during the Skylab missions. Some 20,000 babies succumb to respiratory distress in the U.S. each year, a condition in which lungs progressively lose their ability to oxygenate blood. Both positive and negative pressure techniques have been used - the first to force air into lungs, the second to keep infant's lungs expanded. Negative pressure around chest helps the baby expand his lungs and maintain proper volume of air. If doctors can keep the infant alive for four days, the missing substance in the lungs will usually form in sufficient quantity to permit normal breathing. The Skylab chamber and its leakproof seals were adapted for medical use.

1976-01-01

404

Surveillance for emerging respiratory viruses.  

PubMed

Several new viral respiratory tract infectious diseases with epidemic potential that threaten global health security have emerged in the past 15 years. In 2003, WHO issued a worldwide alert for an unknown emerging illness, later named severe acute respiratory syndrome (SARS). The disease caused by a novel coronavirus (SARS-CoV) rapidly spread worldwide, causing more than 8000 cases and 800 deaths in more than 30 countries with a substantial economic impact. Since then, we have witnessed the emergence of several other viral respiratory pathogens including influenza viruses (avian influenza H5N1, H7N9, and H10N8; variant influenza A H3N2 virus), human adenovirus-14, and Middle East respiratory syndrome coronavirus (MERS-CoV). In response, various surveillance systems have been developed to monitor the emergence of respiratory-tract infections. These include systems based on identification of syndromes, web-based systems, systems that gather health data from health facilities (such as emergency departments and family doctors), and systems that rely on self-reporting by patients. More effective national, regional, and international surveillance systems are required to enable rapid identification of emerging respiratory epidemics, diseases with epidemic potential, their specific microbial cause, origin, mode of acquisition, and transmission dynamics. PMID:25189347

Al-Tawfiq, Jaffar A; Zumla, Alimuddin; Gautret, Philippe; Gray, Gregory C; Hui, David S; Al-Rabeeah, Abdullah A; Memish, Ziad A

2014-10-01

405

Evaluation of Fiber Bundle Rotation for Enhancing Gas Exchange in a Respiratory Assist Catheter  

PubMed Central

Supplemental oxygenation and carbon dioxide removal through an intravenous respiratory assist catheter can be used as a means of treating patients with acute respiratory failure. We are beginning development efforts toward a new respiratory assist catheter with an insertional size <25F, which can be inserted percutaneously. In this study, we evaluated fiber bundle rotation as an improved mechanism for active mixing and enhanced gas exchange in intravenous respiratory assist catheters. Using a simple test apparatus of a rotating densely packed bundle of hollow fiber membranes, water and blood gas exchange levels were evaluated at various rotation speeds in a mock vena cava. At 12,000 RPM, maximum CO2 gas exchange rates were 449 and 523 mL/min per m², water and blood, respectively, but the rate of increase with increasing rotation rate diminished beyond 7500 RPM. These levels of gas exchange efficiency are two? to threefold greater than achieved in our previous respiratory catheters using balloon pulsation for active mixing. In preliminary hemolysis tests, which monitored plasma?free hemoglobin levels in vitro over a period of 6 hours, we established that the rotating fiber bundle per se did not cause significant blood hemolysis compared with an intra?aortic balloon pump. Accordingly, fiber bundle rotation appears to be a potential mechanism for increasing gas exchange and reducing insertional size in respiratory catheters. PMID:17515731

Eash, Heide J.; Mihelc, Kevin M.; Frankowski, Brain J.; Hattler, Brack G.; Federspiel, William J.

2007-01-01

406