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1

Determinants of Noninvasive Ventilation Outcomes during an Episode of Acute Hypercapnic Respiratory Failure in Chronic Obstructive Pulmonary Disease: The Effects of Comorbidities and Causes of Respiratory Failure  

PubMed Central

Objectives. To investigate the effect of the cause of acute respiratory failure and the role of comorbidities both acute and chronic on the outcome of COPD patients admitted to Respiratory Intensive Care Unit (RICU) with acute respiratory failure and treated with NIV. Design. Observational prospective study. Patients and Methods. 176 COPD patients consecutively admitted to our RICU over a period of 3 years and treated with NIV were evaluated. In all patients demographic, clinical, and functional parameters were recorded including the cause of acute respiratory failure, SAPS II score, Charlson comorbidity index, and further comorbidities not listed in the Charlson index. NIV success was defined as clinical improvement leading to discharge to regular ward, while exitus or need for endotracheal intubation was considered failure. Results. NIV outcome was successful in 134 patients while 42 underwent failure. Univariate analysis showed significantly higher SAP II score, Charlson index, prevalence of pneumonia, and lower serum albumin level in the failure group. Multivariate analysis confirmed a significant predictive value for pneumonia and albumin. Conclusions. The most important determinants of NIV outcome in COPD patients are the presence of pneumonia and the level of serum albumin as an indicator of the patient nutritional status. PMID:24563868

Pacilli, Angela Maria Grazia; Valentini, Ilaria; Carbonara, Paolo; Marchetti, Antonio; Nava, Stefano

2014-01-01

2

Acute respiratory failure caused by organizing pneumonia secondary to antineoplastic therapy for non-Hodgkin's lymphoma  

PubMed Central

Interstitial lung diseases belong to a group of diseases that typically exhibit a subacute or chronic progression but that may cause acute respiratory failure. The male patient, who was 37 years of age and undergoing therapy for non-Hodgkin's lymphoma, was admitted with cough, fever, dyspnea and acute hypoxemic respiratory failure. Mechanical ventilation and antibiotic therapy were initiated but were associated with unfavorable progression. Thoracic computed tomography showed bilateral pulmonary "ground glass" opacities. Methylprednisolone pulse therapy was initiated with satisfactory response because the patient had used three drugs related to organizing pneumonia (cyclophosphamide, doxorubicin and rituximab), and the clinical and radiological symptoms were suggestive. Organizing pneumonia may be idiopathic or linked to collagen diseases, drugs and cancer and usually responds to corticosteroid therapy. The diagnosis was anatomopathological, but the patient's clinical condition precluded performing a lung biopsy. Organizing pneumonia should be a differential diagnosis in patients with apparent pneumonia and a progression that is unfavorable to antimicrobial treatment. PMID:23917942

Santana, Adriell Ramalho; Amorim, Fabio Ferreira; Soares, Paulo Henrique Alves; de Moura, Edmilson Bastos; Maia, Marcelo de Oliveira

2012-01-01

3

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

4

Empyema and Respiratory Failure Secondary to Nephropleural Fistula Caused by Chronic Urinary Tract Infection: A Case Report  

PubMed Central

We report a case of nephropleural fistula causing empyema and respiratory failure in a 68-year-old gentleman with a long history of urological problems including recurrent nephrolithiasis and urinary tract infections. He was admitted with sepsis, a productive cough, pyuria, and reduced breath sounds over the left hemithorax. Radiological imaging revealed a fistulous connection between a left-sided perinephric abscess and the pleural space. He was commenced on broad spectrum intravenous antibiotics but developed progressive respiratory failure requiring intensive care admission. Urinary and pleural aspirates cultured facultative anaerobic pathogens with identical resistance patterns. Drainage of thoracic and perinephric collections was carried out, allowing him to be extubated after 24 hours and discharged home after 18 days on an extended course of oral antibiotics. Left nephrectomy is now planned after a period of convalescence. Empyema developing in patients with known urolithiasis should alert the treating physician to the possibility that a pathological communication has formed especially if typical urinary tract pathogens are cultured from respiratory sampling. PMID:23198240

Jones, G. H.; Kalaher, H. R.; Misra, N.; Curtis, J.; Parker, R. J.

2012-01-01

5

Adiaspiromycosis Causing Respiratory Failure and a Review of Human Infections Due to Emmonsia and Chrysosporium spp.  

PubMed Central

We report a case of a 27-year-old male who presented with respiratory distress that required mechanical ventilation. Transbronchial biopsy revealed adiaspores of the fungus Emmonsia crescens within granulomata, a condition known as adiaspiromycosis. The patient received amphotericin products and corticosteroids, followed by itraconazole, and made a full recovery. Emmonsia crescens is a saprobe with a wide distribution that is primarily a rodent pathogen. The clinical characteristics of the 20 cases of human pulmonary adiaspiromycosis reported since the last comprehensive case review in 1993 are described here, as well as other infections recently reported for the genus Emmonsia. Pulmonary adiaspiromycosis has been reported primarily in persons without underlying host factors and has a mild to severe course. It remains uncertain if the optimal management of severe pulmonary adiaspiromycosis is supportive or if should consist of antifungal treatment, corticosteroids, or a combination of the latter two. The classification of fungi currently in the genus Emmonsia has undergone considerable revision since their original description, including being grouped with the genus Chrysosporium at one time. Molecular genetics has clearly differentiated the genus Emmonsia from the Chrysosporium species. Nevertheless, there has been a persistent confusion in the literature regarding the clinical presentation of infection with fungi of these two genera; to clarify this matter, the reported cases of invasive Chrysosporium infections were reviewed. Invasive Chrysosporium infections typically occur in impaired hosts and can have a fatal course. Based on limited in vitro susceptibility data for Chrysosporium zonatum, amphotericin B is the most active drug, itraconazole susceptibility is strain-dependent, and fluconazole and 5-fluorocytosine are not active. PMID:22259200

Sutton, Deanna A.; Graybill, John R.

2012-01-01

6

Acute neuromuscular respiratory failure after ICU discharge  

Microsoft Academic Search

Objective: To describe a syndrome of acute neuromuscular respiratory failure (NM-ARF) caused by ICU-acquired acute myopathy and neuropathy.Design: Case series.Setting: General Regional University Hospital in Brescia, Italy.Patients: Five adult patients with NM-ARF after prolonged ICU stay and successful weaning from the ventilator and ICU discharge.Interventions: None.Measurements: Clinical signs of NM-ARF, electroneurography and electromyography (ENMG) of peripheral nerves and muscles, and

N. Latronico; B. Guarneri; S. Alongi; G. Bussi; A. Candiani

1999-01-01

7

ABCA3 inactivation in mice causes respiratory failure, loss of pulmonary surfactant, and depletion of lung phosphatidylglycerol  

Microsoft Academic Search

The highly branched mammalian lung relies on surfactant, a mixture of phospholipids, cholesterol, and hy- drophobic proteins, to reduce intraalveolar surface tension and prevent lung collapse. Human mutations in the ABCA3 transporter have been associated with childhood respiratory disease of variable severity and onset. Here, we report the generation of Abca3 null mice, which became lethargic and cyanotic and died

Michael L. Fitzgerald; Ramnik Xavier; Kathleen J. Haley; Ruth Welti; Julie L. Goss; Cari E. Brown; Debbie Z. Zhuang; Susan A. Bell; Naifang Lu; Mary Mckee; Brian Seed; Mason W. Freeman

2006-01-01

8

Two different causes of acute respiratory failure in a patient with diffuse idiopathic skeletal hyperostosis and ankylosed cervical spine  

Microsoft Academic Search

We report a case of 73-year-old man with massive hyperostosis of the cervical spine associated with diffuse idiopathic skeletal\\u000a hyperostosis (DISH), resulting in dysphagia, hoarseness and acute respiratory insufficiency. An emergency operation was performed,\\u000a which involved excision of osteophytes at the level of C6–C7, compressing the trachea against enlarged sternoclavicular joints,\\u000a also affected by DISH. Approximately 3 years later, the patient

Rok Vengust; René Mihali?; Matjaž Turel

2010-01-01

9

Lessons to be learned: a case study approach. Bronchiolitis obliterans organising pneumonia: a reversible cause of respiratory failure.  

PubMed

A 70-year-old lady was admitted to hospital through the casualty department with suspected bilateral community acquired pneumonia. Although she received intravenous antibiotics, high concentrations of supplemental inhaled oxygen and continuous positive airway pressure therapy there was failure to respond. Abnormal levels of peripheral blood neutrophil and eosinophil counts as well as computerised tomography chest scan appearances suggested bronchiolitis obliterans organising pneumonia. The diagnosis was confirmed by a lung biopsy obtained by video-assisted thoracoscopy under general anaesthesia. She made a prompt and complete recovery with oral steroid treatment. PMID:15301319

Mohan, Kamlesh; Sayer, Richard; Acharya, Devikumar

2004-07-01

10

Therapy for respiratory tract infections caused by respiratory syncytial virus  

Microsoft Academic Search

Respiratory syncytial virus (RSV) is the most common viral cause of lower respiratory tract infection (LRTI) in infancy and\\u000a young children. No effective treatment for RSV lower respiratory tract infection (RSV-LRTI) exists. Ribavirin initially proved\\u000a to be an effective anti-viral drug for RSV-LTRI. However, subsequently performed trials could not reproduce these positive\\u000a results and, based on the current available evidence,

Job van Woensel; Jan Kimpen

2000-01-01

11

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

12

Bladder stone causing renal failure.  

PubMed

We describe a 62-year-old man with a large bladder calculus causing bilateral ureteral obstruction. Diagnosis was delayed despite the patient's history of recurrent urinary infections. This case report illustrates the importance of radiological evaluation of patients presenting with recurrent urinary infections. To our knowledge, only three previous reports of bladder stone causing renal failure have been published. PMID:9322416

Sundaram, C P; Houshiar, A M; Reddy, P K

1997-09-01

13

ECMO for adult respiratory failure: current use and evolving applications.  

PubMed

Extracorporeal membrane oxygenation (ECMO) is increasingly being used to support adults with severe forms of respiratory failure. Fueling the explosive growth is a combination of technological improvements and accumulating, although controversial, evidence. Current use of ECMO extends beyond its most familiar role in the support of patients with severe acute respiratory distress syndrome (ARDS) to treat patients with various forms of severe hypoxemic or hypercapnic respiratory failure, ranging from bridging patients to lung transplantation to managing pulmonary hypertensive crises. The role of ECMO used primarily for extracorporeal carbon dioxide removal (ECCO2R) in the support of patients with hypercapnic respiratory failure and less severe forms of ARDS is also evolving. Select patients with respiratory failure may be liberated from invasive mechanical ventilation altogether and some may undergo extensive physical therapy while receiving extracorporeal support. Current research may yield a true artificial lung with the potential to change the paradigm of treatment for adults with chronic respiratory failure. PMID:24625534

Agerstrand, Cara L; Bacchetta, Matthew D; Brodie, Daniel

2014-01-01

14

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

15

Intercostal and forearm muscle deoxygenation during respiratory fatigue in patients with heart failure: potential role of a respiratory muscle metaboreflex.  

PubMed

The purpose of this study was to determine the effect of respiratory muscle fatigue on intercostal and forearm muscle perfusion and oxygenation in patients with heart failure. Five clinically stable heart failure patients with respiratory muscle weakness (age, 66±12 years; left ventricle ejection fraction, 34±3%) and nine matched healthy controls underwent a respiratory muscle fatigue protocol, breathing against a fixed resistance at 60% of their maximal inspiratory pressure for as long as they could sustain the predetermined inspiratory pressure. Intercostal and forearm muscle blood volume and oxygenation were continuously monitored by near-infrared spectroscopy with transducers placed on the seventh left intercostal space and the left forearm. Data were compared by two-way ANOVA and Bonferroni correction. Respiratory fatigue occurred at 5.1±1.3 min in heart failure patients and at 9.3±1.4 min in controls (P<0.05), but perceived effort, changes in heart rate, and in systolic blood pressure were similar between groups (P>0.05). Respiratory fatigue in heart failure reduced intercostal and forearm muscle blood volume (P<0.05) along with decreased tissue oxygenation both in intercostal (heart failure, -2.6±1.6%; controls, +1.6±0.5%; P<0.05) and in forearm muscles (heart failure, -4.5±0.5%; controls, +0.5±0.8%; P<0.05). These results suggest that respiratory fatigue in patients with heart failure causes an oxygen demand/delivery mismatch in respiratory muscles, probably leading to a reflex reduction in peripheral limb muscle perfusion, featuring a respiratory metaboreflex. PMID:25296359

Moreno, A M; Castro, R R T; Silva, B M; Villacorta, H; Junior, M Sant'Anna; Nóbrega, A C L

2014-11-01

16

Prevention of nosocomial infections in acute respiratory failure patients  

Microsoft Academic Search

Patients with acute respiratory failure are predisposed to acquire nosocomial infection primarily because they may need ventilatory support, usually invasive mechanical ventilation. The presence of an endotracheal tube impairs natural defences of the respiratory tract and favours airways colonisation and lung infection. Cross transmission of microorganisms may also occur via contaminated hands of healthcare workers that manipulate invasive devices. Thus,

E. Girou

2003-01-01

17

Structural failures: Causes, prevention, and misinterpretation  

SciTech Connect

This article presents a few observations on causes and prevention of failures in structural and equipment components that are related to the initiation and propagation of fatigue cracks. Some of these observations are illustrated by using actual failures. Also, the article presents a discussion of some common misconceptions and misinterpretations that have led to incorrect conclusions in failure investigations.

Barsom, J.M. (US Steel, Pittsburgh, PA (United States))

1993-07-01

18

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

19

Common Cause Failure Modeling: Aerospace Versus Nuclear  

NASA Technical Reports Server (NTRS)

Aggregate nuclear plant failure data is used to produce generic common-cause factors that are specifically for use in the common-cause failure models of NUREG/CR-5485. Furthermore, the models presented in NUREG/CR-5485 are specifically designed to incorporate two significantly distinct assumptions about the methods of surveillance testing from whence this aggregate failure data came. What are the implications of using these NUREG generic factors to model the common-cause failures of aerospace systems? Herein, the implications of using the NUREG generic factors in the modeling of aerospace systems are investigated in detail and strong recommendations for modeling the common-cause failures of aerospace systems are given.

Stott, James E.; Britton, Paul; Ring, Robert W.; Hark, Frank; Hatfield, G. Spencer

2010-01-01

20

[The effect of non-invasive mechanical ventilation in postoperative respiratory failure].  

PubMed

Postoperative respiratory failure is related with the highest mortality and morbidity among all perioperative complications. The most common underlying mechanism of postoperative respiratory failure is the development of atelectasis. Anaesthesia, medications which cause respiratory depression, high FiO2 use, postoperative pain and disruption of muscle forces due to surgery leads to decrease in functional residual capacity and results in atelectasis formation. Atelectasis causes severe hypoxemia due to ventilation, perfusion mismatch, shunt and increased peripheral vascular resistance. Intrathoracic positive pressure is an effective therapeutic option in both prevention and treatment of atelectasis. Non-invasive mechanical ventilation is related with a lower mortality and morbidity rate due to lack of any potential complication risks of endotracheal intubation. Non-invasive mechanical ventilation can be applied as prophylactic or curative. Both of these techniques are related with lower reintubation rates, nosocomial infections, duration of hospitalization and mortality in patients with postoperative respiratory failure. The differences of this therapy from standard application and potential complications should be well known in order to improve prognosis in these group of patients. The primary aim of this review is to underline the pathogenesis of postoperative respiratory failure. The secondary aim is to clarify the optimum method, effect and complications of non-invasive mechanical ventilation therapy under the light of the studies which was performed in specific patient groups. PMID:22779943

Ozy?lmaz, Ezgi; Kaya, Ak?n

2012-01-01

21

Positive-Pressure Ventilation Equipment for Mass Casualty Respiratory Failure  

Microsoft Academic Search

In the event of an influenza pandemic, patients with severe acute respiratory failure (ARF) due to in- fluenza will require positive-pressure ventilation (PPV) in order to survive. In countries with widely available critical care services, PPV is delivered almost exclusively through use of full-feature me- chanical ventilators in intensive care units (ICUs) or specialized hospital wards. But the supply of

Lewis Rubinson; Richard D. Branson; Nicki Pesik; Daniel Talmor

2006-01-01

22

Genetic causes of spermatogenic failure  

PubMed Central

Approximately 10%–15% of couples are infertile, and a male factor is involved in almost half of these cases. This observation is due in part to defects in spermatogenesis, and the underlying causes, including genetic abnormalities, remain largely unknown. Until recently, the only genetic tests used in the diagnosis of male infertility were aimed at detecting the presence of microdeletions of the long arm of the Y chromosome and/or chromosomal abnormalities. Various other single-gene or polygenic defects have been proposed to be involved in male fertility. However, their causative effects often remain unproven. The recent evolution in the development of whole-genome-based techniques and the large-scale analysis of mouse models might help in this process. Through knockout mouse models, at least 388 genes have been shown to be associated with spermatogenesis in mice. However, problems often arise when translating this information from mice to humans. PMID:22138898

Massart, Annelien; Lissens, Willy; Tournaye, Herman; Stouffs, Katrien

2012-01-01

23

Acute respiratory failure in kidney transplant recipients: a multicenter study  

PubMed Central

Introduction Data on pulmonary complications in renal transplant recipients are scarce. The aim of this study was to evaluate acute respiratory failure (ARF) in renal transplant recipients. Methods We conducted a retrospective observational study in nine transplant centers of consecutive kidney transplant recipients admitted to the intensive care unit (ICU) for ARF from 2000 to 2008. Results Of 6,819 kidney transplant recipients, 452 (6.6%) required ICU admission, including 200 admitted for ARF. Fifteen (7.5%) of these patients had combined kidney-pancreas transplantations. The most common causes of ARF were bacterial pneumonia (35.5%), cardiogenic pulmonary edema (24.5%) and extrapulmonary acute respiratory distress syndrome (ARDS) (15.5%). Pneumocystis pneumonia occurred in 11.5% of patients. Mechanical ventilation was used in 93 patients (46.5%), vasopressors were used in 82 patients (41%) and dialysis was administered in 104 patients (52%). Both the in-hospital and 90-day mortality rates were 22.5%. Among the 155 day 90 survivors, 115 patients (74.2%) were dialysis-free, including 75 patients (65.2%) who recovered prior renal function. Factors independently associated with in-hospital mortality were shock at admission (odds ratio (OR) 8.70, 95% confidence interval (95% CI) 3.25 to 23.29), opportunistic fungal infection (OR 7.08, 95% CI 2.32 to 21.60) and bacterial infection (OR 2.53, 95% CI 1.07 to 5.96). Five factors were independently associated with day 90 dialysis-free survival: renal Sequential Organ Failure Assessment (SOFA) score on day 1 (OR 0.68/SOFA point, 95% CI 0.52 to 0.88), bacterial infection (OR 0.43, 95% CI 0.21 to 0.90), three or four quadrants involved on chest X-ray (OR 0.44, 95% CI 0.21 to 0.91), time from hospital to ICU admission (OR 0.98/day, 95% CI 0.95 to 0.99) and oxygen flow at admission (OR 0.93/liter, 95% CI 0.86 to 0.99). Conclusions In kidney transplant recipients, ARF is associated with high mortality and graft loss rates. Increased Pneumocystis and bacterial prophylaxis might improve these outcomes. Early ICU admission might prevent graft loss. PMID:21385434

2011-01-01

24

[Non-invasive ventilation: indication for acute respiratory failure].  

PubMed

Mask or Non-invasive ventilation (NIV) is used for critically ill patients with acute respiratory failure (ARF): acute exacerbation of chronic obstructive bronchopulmonary disease and severe cardiogenic pulmonary edema are considered as the best indications for NIV since it improves the outcome of these patients. This technique is also proposed for hypoxemic respiratory failure, with more various results. To be effective here, NIV must be established early enough and should not delay intubation if required. NIV is also proposed after invasive ventilation or in patients in whom endotracheal intubation is not desirable. Its use has increased and its effectiveness seems to have improved, due to a better understanding of the technique but also thanks to technological progress. PMID:23346673

Brunner, Marie-Eve; Lyazidi, Aissam; Richard, Jean-Christophe Marie; Brochard, Laurent

2012-12-12

25

Bench-to-bedside review: Weaning failure – should we rest the respiratory muscles with controlled mechanical ventilation?  

Microsoft Academic Search

The use of controlled mechanical ventilation (CMV) in patients who experience weaning failure after a spontaneous breathing trial or after extubation is a strategy based on the premise that respiratory muscle fatigue (requiring rest to recover) is the cause of weaning failure. Recent evidence, however, does not support the existence of low frequency fatigue (the type of fatigue that is

Theodoros Vassilakopoulos; Spyros Zakynthinos; Charis Roussos

2005-01-01

26

Efficacy of intraoperative, single-bolus corticosteroid administration to prevent postoperative acute respiratory failure after oesophageal cancer surgery  

PubMed Central

OBJECTIVES Respiratory failure from acute lung injury (ALI), acute respiratory distress syndrome (ARDS) and pneumonia are the major cause of morbidity and mortality following an oesophagectomy for oesophageal cancer. This study was performed to investigate whether an intraoperative corticosteroid can attenuate postoperative respiratory failure. METHODS Between November 2005 and December 2008, 234 consecutive patients who underwent an oesophagectomy for oesophageal cancer were reviewed. A 125-mg dose of methylprednisolone was administered after performing the anastomosis. ALI, ARDS and pneumonia occurring before postoperative day (POD) 7 were regarded as acute respiratory failure. RESULT The mean age was 64.2 ± 8.7 years. One hundred and fifty-one patients were in the control group and 83 patients in the steroid group. Patients' characteristics were comparable. The incidence of acute respiratory failure was lower in the steroid group (P = 0.037). The incidences of anastomotic leakage and wound dehiscence were not different (P = 0.57 and P = 1.0). The C-reactive protein level on POD 2 was lower in the steroid group (P < 0.005). Multivariate analysis indicates that the intraoperative steroid was a protective factor against acute respiratory failure (P = 0.046, OR = 0.206). CONCLUSIONS Intraoperative corticosteroid administration was associated with a decreased risk of acute respiratory failure following an oesophagectomy. The laboratory data suggest that corticosteroids may attenuate the stress-induced inflammatory responses after surgery. PMID:22745302

Park, Seong Yong; Lee, Hyun-Sung; Jang, Hee-Jin; Joo, Jungnam; Zo, Jae Ill

2012-01-01

27

The usefulness of combined high-frequency percussive ventilation during acute respiratory failure after smoke inhalation.  

PubMed

Inhalation injury and bacterial pneumonia represent some of the most important causes of mortality in burn patients. We describe 11 severely burned patients with acute respiratory failure due to inhalation injury who did not respond adequately to conventional respiratory support. High-frequency percussive ventilation (HFPV) is a recent ventilatory mode, which combines the advantages of conventional ventilation with some of those of high-frequency ventilation. Seven patients developed pulmonary infection during the acute phase; one patient died of multiple organ failure on day 25. All the other patients survived; two developed bronchiolitis obliterans symptoms before discharge. No side-effects were noted and haemodynamic tolerance of HFPV was excellent. Our findings suggest that HFPV can improve pulmonary function and gas exchange in these catastrophic pulmonary failures following inhalation injury. PMID:9601588

Reper, P; Dankaert, R; van Hille, F; van Laeke, P; Duinslaeger, L; Vanderkelen, A

1998-02-01

28

Optimizing Noninvasive Ventilation in Hematological Patients with Acute Respiratory Failure  

Microsoft Academic Search

\\u000a In hematological patients with acute respiratory failure (ARF), recourse to mechanical ventilation is still associated with\\u000a increased mortality, although the prognosis has improved during the last decade. Thus, avoiding intubation remains a major\\u000a objective. Noninvasive ventilation (NIV) has mainly been validated among onco-hematology patients with ARF. Above all, NIV\\u000a makes it possible to reduce the mortality of these patients.\\u000a \\u000a \\u000a Before

Gilles Hilbert

29

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

30

[Depression of testosterone secretion in male patients with respiratory failure].  

PubMed

To investigate the changes of testosterone (T) secretion under sustained hypoxia, we determined basal levels of urine T, 17 ketosteroid, luteinizing hormone releasing hormone (LHRH), luteinizing hormone (LH), follicle stimulating hormone (FSH) and response to LHRH and HCG (human chorionic gonadotropin) in male patients with respiratory failure. After evaluating blood gas data, we also measured serum T, LH, FSH, plasma progesterone (P) and 17 hydroxyprogesterone (17OH-P). The subjects were divided into 3 groups according to PaO2; Group 1 with a PaO2 under 60 Torr, Group 2 with a PaO2 between 60 Torr and under 70 Torr, Group 3 was an age-matched control group. Urine T and serum T were significantly lower in Group 1 compared with those of Group 3. In the LHRH test, augmented relative responsiveness and delayed peak value in LH secretion were observed in Group 1, compared with those of Group 3. As for the HCG test, no differences were observed among the 3 groups. The ratio of 17OH-P to P, which indicates activity of 17-hydroxylase, was observed to be diminished with increasing degrees of hypoxia. These data suggest that in male patients with respiratory failure there was depression in T secretion as well as 17-hydroxylase activity due to hypothalamic-pituitary hypofunction. PMID:2615089

Kouchiyama, S; Shinozaki, T; Masuyama, S; Tatsumi, K; Kimura, H; Kuriyama, T

1989-03-01

31

Respiratory failure and mechanical ventilation: Pathophysiology and methods of promoting weaning  

Microsoft Academic Search

Respiratory failure may be manifested either by impaired gas exchange or by impaired ventilatory function. The latter results\\u000a in more severe problems in weaning patients from mechanical ventilation. Ventilatory failure may result from inadequate respiratory\\u000a drive, excessive respiratory workload, inadequate respiratory muscle endurance, or a combination of these factors.\\u000a \\u000a Simple bedside tests of ventilatory function are useful for evaluating the

Jill P. Karpel; Thomas K. Aldrich

1986-01-01

32

Determinants of Noninvasive Ventilation Success or Failure in Morbidly Obese Patients in Acute Respiratory Failure  

PubMed Central

Purpose Acute respiratory failure (ARF) is a common life-threatening complication in morbidly obese patients with obesity hypoventilation syndrome (OHS). We aimed to identify the determinants of noninvasive ventilation (NIV) success or failure for this indication. Methods We prospectively included 76 consecutive patients with BMI>40 kg/m2 diagnosed with OHS and treated by NIV for ARF in a 15-bed ICU of a tertiary hospital. Results NIV failed to reverse ARF in only 13 patients. Factors associated with NIV failure included pneumonia (n?=?12/13, 92% vs n?=?9/63, 14%; p<0.0001), high SOFA (10 vs 5; p<0.0001) and SAPS2 score (63 vs 39; p<0.0001) at admission. These patients often experienced poor outcome despite early resort to endotracheal intubation (in-hospital mortality, 92.3% vs 17.5%; p<0.001). The only factor significantly associated with successful response to NIV was idiopathic decompensation of OHS (n?=?30, 48% vs n?=?0, 0%; p?=?0.001). In the NIV success group (n?=?63), 33 patients (53%) experienced a delayed response to NIV (with persistent hypercapnic acidosis during the first 6 hours). Conclusions Multiple organ failure and pneumonia were the main factors associated with NIV failure and death in morbidly obese patients in hypoxemic ARF. On the opposite, NIV was constantly successful and could be safely pushed further in case of severe hypercapnic acute respiratory decompensation of OHS. PMID:24819141

Lemyze, Malcolm; Taufour, Pauline; Duhamel, Alain; Temime, Johanna; Nigeon, Olivier; Vangrunderbeeck, Nicolas; Barrailler, Stephanie; Gasan, Gaelle; Pepy, Florent; Thevenin, Didier; Mallat, Jihad

2014-01-01

33

An undiagnosed myasthenia gravis presenting as isolated recurrent acute respiratory failure  

PubMed Central

Acute respiratory failure is an uncommon initial presentation of myasthenia gravis (MG). In our case a 22-year-old woman of unrecognized MG presented to the emergency department with isolated respiratory failure as the first presenting symptom. Initially she presented with dysphonia and was managed by speech therapist and ENT surgeons for 3 months. Subsequently, she presented with signs and symptoms of sepsis and went into acute respiratory failure. This case highlights the need to consider MG in the differential diagnosis of an otherwise unexplained respiratory failure in the critical care setting. PMID:22346203

Sharma, Shri Ram; Sharma, Nalini; Yeolekar, ME

2012-01-01

34

Extracorporeal membrane oxygenation for severe acute respiratory failure  

PubMed Central

Extracorporeal membrane oxygenation (ECMO) is a technique for providing life support, in case the natural lungs are failing and are not able to maintain a sufficient oxygenation of the body's organ systems. ECMO technique was an adaptation of conventional cardiopulmonary bypass technique and introduced into treatment of severe acute respiratory distress syndrome (ARDS) in the 1970s. The intial reports of the use of ECMO in ARDS patients were quite enthusiastic, however, in the following years it became clear that ECMO was only of benefit in newborns with acute respiratory failure. In neonates treated with ECMO, survival rates of 80% could be achieved. In adult patients with ARDS, two large randomized controlled trials (RCTs) published in 1979 and 1994 failed to show an advantage of ECMO over convential treatment, survival rates were only 10% and 33%, respectively, in the ECMO groups. Since then, ECMO technology as well as conventional treatment of adult ARDS have undergone further improvements. In conventional treatment lung-protective ventilation strategies were introduced and ECMO was made safer by applying heparin-coated equipment, membranes and tubings. Many ECMO centres now use these advanced ECMO technology and report survival rates in excess of 50% in uncontrolled data collections. The question, however, of whether the improved ECMO can really challenge the advanced conventional treatment of adult ARDS is unanswered and will need evaluation by a future RCT. PMID:11094500

Lewandowski, Klaus

2000-01-01

35

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

36

Neonatal Respiratory Failure: A 12Month Clinical Epidemiologic Study From 2004 to 2005 in China  

Microsoft Academic Search

OBJECTIVES.In the past decade, neonatal special care services in China have been established, during which time various therapies for neonatal respiratory failure have been introduced. The objective of this study was to investigate the incidence, man- agement, outcome, and cost of neonatal respiratory failure treated by mechanical ventilation in 23 tertiary NICUs of major hospitals in southeastern and midwestern China.

Liling Qian; Cuiqing Liu; Wanzhu Zhuang; Yunxia Guo; Jialin Yu; Hanqiang Chen; Sannan Wang; Zhenlang Lin; Shiwen Xia; Xiaohong Liu; Chao Chen; Bo Sun

2009-01-01

37

"Causes of death in asthma, COPD and non-respiratory hospitalized patients: a multicentric study"  

PubMed Central

Background There is limited information on the causes of death in asthma patients. To determine the causes of death in hospitalized asthmatic patients and to compare with those observed in COPD patients and non-respiratory individuals, with a particular interest in associations with previous cardiovascular disease. Methods Retrospective case–control study which analyzed the deaths of all hospitalized patients admitted for any reason during January, April, July and October of 2008 in 13 Spanish centers. Medical records of deceased patients were reviewed, and demographic and clinical data were collected. Results A total of 2,826 deaths (mean age 75 years, 56% men) were included in the analysis, of which 82 (2.9%) were of patients with asthma and 283 (10%) with COPD. The most common causes of death in asthma patients were cardiovascular diseases (29.3%), malignancies (20.7%) and infections (14.6%); in COPD patients they were malignancies (26.5%), acute respiratory failure (25.8%) and cardiovascular diseases (21.6%). Asthma, compared to COPD patients, died significantly less frequently from acute respiratory failure and lung cancer. A multivariate logistic regression analysis failed to associate asthma with cardiovascular deaths. Conclusions Cardiovascular disease is the most frequent cause of death among hospitalized asthma patients. The specific causes of death differ between asthma and COPD patients. PMID:24321217

2013-01-01

38

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

39

The Microcirculation Is Unchanged in Neonates with Severe Respiratory Failure after the Initiation of ECMO Treatment  

Microsoft Academic Search

Purpose. Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is known to improve cardiorespiratory function and outcome in neonates with severe respiratory failure. We tested the hypothesis that VA-ECMO therapy improves the microcircu- lation in neonates with severe respiratory failure. Methods. This single-center prospective observational pilot study took place in an intensive care unit of a level III university children’s hospital. Twenty-one-term neonates,

A. P. C. Top; E. A. B. Buijs; Dijk van M; D. Tibboel; C. Ince

2012-01-01

40

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

41

Hereditary myopathy with early respiratory failure is associated with misfolding of the titin fibronectin III 119 subdomain.  

PubMed

Hereditary myopathy with early respiratory failure is a rare disease with muscle weakness and respiratory failure as early symptoms. Muscle pathology is characterized by the presence of multiple cytoplasmic bodies and other protein aggregates in muscle fibers. The disease is associated with mutations in the titin gene (TTN). All patients harbor mutations located in exon 343 in the TTN gene that codes for the fibronectin III domain 119 (FN3 119) in the 10th motif of the 11-element motif A-band super-repeat. We investigated how such disease-causing mutations affect the biochemical behavior of this titin domain. All five disease-causing amino acid changes analyzed by us (p.P30068R, p.C30071R, p.W30088R, p.W30088C and p.P30091L) resulted in impaired FN3 119 domain solubility. In contrast, amino acid changes associated with common SNPs (p.V30076I, p.R30107C and p.S30125F) did not have this effect. In silico analyses further support the notion that disease-causing mutations impair proper folding of the FN3 119 domain. The results suggest that hereditary myopathy with early respiratory failure is caused by defective protein folding. PMID:24636144

Hedberg, Carola; Toledo, Alejandro Gomez; Gustafsson, Claes M; Larson, Göran; Oldfors, Anders; Macao, Bertil

2014-05-01

42

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

43

Intravenous colistin-induced acute respiratory failure: A case report and a review of literature  

PubMed Central

The emergence of multi-drug-resistant gram negative bacillary infections has regained popularity of ancient drugs such as polymyxins. We report a case of acute respiratory failure induced by use of intravenous colistimethate, which is one of the forms of polymyxin. The patient is a 31 year old female with paraplegia due to spina bifida who underwent excisional debridement of large lumbosacral decubitus ulcer with osteomyelitis infected with pan-resistant Pseudomonas aeruginosa and MRSA. Six days after initiation of intravenous colistimethate and vancomycin, she developed acute respiratory failure requiring mechanical ventilation. Pan-culture was negative including a chest radiograph. V/Q scan showed low probability for pulmonary embolism. Echocardiogram showed normal right ventricle with no strain or pulmonary hypertension. Colistimethate was discontinued. Within 24 hours, she was extubated. In the early years after introduction of polymyxin, there were several reports of acute respiratory paralysis. The mechanism is thought to be noncompetitive myoneuronal presynaptic blockade of acetylcholine release. Though a direct causal relationship for respiratory failure is often difficult to establish in current era with multiple co morbidities, the timeframe of apnea, acuity of onset as well as rapid recovery in our case clearly point out the causal relationship. In addition, our patient also developed acute renal failure, presumably due to colistimethate induced nephrotoxicity, a possible contributing factor for her acute respiratory failure. In summary, colistimethate can induce acute neurotoxicity including respiratory muscular weakness and acute respiratory failure. Clinicians should consider its toxicity in the differential diagnosis of acute respiratory failure especially in critically ill patients.

Shrestha, Amardeep; Soriano, Sheryll Mae; Song, Mingchen; Chihara, Shingo

2014-01-01

44

Respiratory disease in Niemann-Pick type C2 is caused by pulmonary alveolar proteinosis.  

PubMed

Niemann-Pick diseases are hereditary neurovisceral lysosomal lipid storage disorders, of which the rare type C2 almost uniformly presents with respiratory distress in early infancy. In the patient presented here, the NPC2 exon 4 frameshift mutation c.408_409delAA caused reduced NPC2 protein levels in serum and lung lavage fluid and the synthesis of an aberrant, larger sized protein of around 28 kDa. Protein expression was strongly reduced also in alveolar macrophages. The infant developed failure to thrive and tachypnea. Lung lavage, computer tomography, and histology showed typical signs of pulmonary alveolar proteinosis with an abnormal intraalveolar accumulation of surfactant as well as macrophages. An NPC2-hypomorph animal model also showed pulmonary alveolar proteinosis and accumulation of macrophages in the lung, liver, and spleen long before the mice died. Due to the elevation of cholesterol, the surfactant had an abnormal composition and function. Despite the removal of large amounts of surfactant from the lungs by therapeutic lung lavages, this treatment was only temporarily successful and the infant died of respiratory failure. Our data indicate that respiratory distress in NPC2 disease is associated with a loss of normal NPC2 protein expression in alveolar macrophages and the accumulation of functionally inactive surfactant rich in cholesterol. PMID:20002450

Griese, M; Brasch, F; Aldana, V R; Cabrera, M M; Goelnitz, U; Ikonen, E; Karam, B J; Liebisch, G; Linder, M D; Lohse, P; Meyer, W; Schmitz, G; Pamir, A; Ripper, J; Rolfs, A; Schams, A; Lezana, F J

2010-02-01

45

What causes the symptoms of heart failure?  

Microsoft Academic Search

hronic heart failure (CHF) is a com- mon condition with a poor prognosis. It is associated with debilitating limit- ing symptoms, even with optimal modern medical management. Foremost among these symptoms is severe exercise intolerance with pronounced fatigue and dyspnoea at low exer- cise workloads. The UK National Health Serv- ice has highlighted it as a key target for improved

Andrew J S Coats

2001-01-01

46

Relationships between ventilatory impairment, sleep hypoventilation and type 2 respiratory failure.  

PubMed

Conditions that increase load on respiratory muscles and/or reduce their capacity to cope with this load predispose to type 2 (hypercapnic) respiratory failure. In its milder forms, this imbalance between load and capacity may primarily manifest as sleep hypoventilation which, if untreated, can increase the likelihood of wakeful respiratory failure. Such problems are commonly seen in progressive respiratory neuromuscular disorders, morbid obesity and chronic obstructive pulmonary disease, either separately or together. Identifying patients at risk can be important in determining whether and when to intervene with treatments such as non-invasive ventilatory assistance. Measurements of wakeful respiratory function are fundamental to this risk assessment. These issues are reviewed in this paper. PMID:25219542

Hillman, David; Singh, Bhajan; McArdle, Nigel; Eastwood, Peter

2014-11-01

47

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

48

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

49

The Role of Corticosteroids in Adult Respiratory Distress Syndrome caused by Viridans Group Streptococci Bacteremia in Neutropenic Patients  

PubMed Central

In the past decades, viridans group Streptococci (VGS) have emerged as an important cause of bacteremia in neutropenic patients with cancer. The clinical course of VGS bacteremia can be devastating including septic shock and adult respiratory distress syndrome (ARDS). It has been suggested that septicemia with VGS triggers the development of noncardiogenic pulmonary edema in patients with pre-existing damage of the lungs due to aggressive cytotoxic treatment. Thus, the preemptive administration of corticosteroid to patients diagnosed with VGS bacteremia with early onset of respiratory failure has been employed to prevent ARDS. While this management strategy has been suggested in the literature, little published data are available to validate this practice. In this study, we sought to review the benefit of early administration of corticosteroid to patients who developed symptom or early signs of respiratory failure while being neutropenic with VGS bacteremia.

Yacoub, Abraham T.; Mojica, Lysenia; Jones, Lily; Knab, Andrea; Alrabaa, Sally; Greene, John

2014-01-01

50

Doxofylline and respiratory mechanics. Short-term effects in mechanically ventilated patients with airflow obstruction and respiratory failure.  

PubMed

To assess the short-term effects of a methylxanthine (doxofylline) on respiratory mechanics in mechanically ventilated patients with airway obstruction and respiratory failure, nine consecutive patients were examined within three days from the onset of mechanical ventilation. Flow, changes in pulmonary volume, and Paw were measured using a ventilator (Servo 900C). End-expiratory and end-inspiratory airway occlusion was performed to measure PEEPi, Cstrs, Rrsmax, and Rrsmin. Measurements were performed before and at 5, 15, and 30 minutes after an intravenous loading dose of doxofylline (5 to 6 mg/kg). We found that doxofylline determined, on the average, a marked decrease in respiratory resistance (Rrsmax and Rrsmin, -27.2 percent and -36.5 percent, respectively) without significant changes in Cstrs and Pmax. The PEEPi, reflecting pulmonary dynamic hyperinflation, was also significantly decreased by doxofylline (-41 percent, on the average). The Pmax was not reliable for evaluation of a single patient, since changes in the elastic pressure can offset changes in the resistive one. No patient experienced significant side effects due to doxofylline. We conclude that (1) the effects of therapy can be assessed noninvasively at bedside in critically ill patients; (2) doxofylline is a rapid and efficient bronchodilator in mechanically ventilated patients with ARF and airflow obstruction; and (3) the decrease in the respiratory resistance and PEEPi, associated with an improved mechanical efficiency of the respiratory muscles at a lower pulmonary volume, can provide better conditions for the patient-ventilator interaction and for weaning. PMID:2791671

Poggi, R; Brandolese, R; Bernasconi, M; Manzin, E; Rossi, A

1989-10-01

51

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

52

Severe Transient Cardiac Failure Caused by Placental Chorangiosis  

Microsoft Academic Search

Background: Chorangiomas are villous capillary tumors of the placenta with high impact on neonatal morbidity and mortality. Cardiac complications have occasionally been reported. Objective: To elucidate clinical features, diagnosis and treatment of cardiac failure caused by chorangiomas. Method:We report a case of a newborn, in whom massive chorangiomas were associated with severe cardiac failure, anemia, and thrombocytopenia. Results: Chorangiosis was

Thomas Schmitz; Bernd Opgen-Rhein; Peter Kroschwald; Gunnar Schroeder; Sven Weber; Christoph Czernik; Michael Obladen

2007-01-01

53

Central nervous system alterations caused by infection with the human respiratory syncytial virus.  

PubMed

Worldwide, the human respiratory syncytial virus (hRSV) is the leading cause of infant hospitalization because of acute respiratory tract infections, including severe bronchiolitis and pneumonia. Despite intense research, to date there is neither vaccine nor treatment available to control hRSV disease burden globally. After infection, an incubation period of 3-5?days is usually followed by symptoms, such as cough and low-grade fever. However, hRSV infection can also produce a larger variety of symptoms, some of which relate to the individual's age at infection. Indeed, infants can display severe symptoms, such as dyspnea and chest wall retractions. Upon examination, crackles and wheezes are also common features that suggest infection by hRSV. Additionally, infection in infants younger than 1?year is associated with several non-specific symptoms, such as failure to thrive, periodic breathing or apnea, and feeding difficulties that usually require hospitalization. Recently, neurological symptoms have also been associated with hRSV respiratory infection and include seizures, central apnea, lethargy, feeding or swallowing difficulties, abnormalities in muscle tone, strabismus, abnormalities in the CSF, and encephalopathy. Here, we discuss recent findings linking the neurological, extrapulmonary effects of hRSV with infection and functional impairment of the CNS. Copyright © 2014 John Wiley & Sons, Ltd. PMID:25316031

Bohmwald, Karen; Espinoza, Janyra A; González, Pablo A; Bueno, Susan M; Riedel, Claudia A; Kalergis, Alexis M

2014-11-01

54

Respiratory chain complex I deficiency caused by mitochondrial DNA mutations  

PubMed Central

Defects of the mitochondrial respiratory chain are associated with a diverse spectrum of clinical phenotypes, and may be caused by mutations in either the nuclear or the mitochondrial genome (mitochondrial DNA (mtDNA)). Isolated complex I deficiency is the most common enzyme defect in mitochondrial disorders, particularly in children in whom family history is often consistent with sporadic or autosomal recessive inheritance, implicating a nuclear genetic cause. In contrast, although a number of recurrent, pathogenic mtDNA mutations have been described, historically, these have been perceived as rare causes of paediatric complex I deficiency. We reviewed the clinical and genetic findings in a large cohort of 109 paediatric patients with isolated complex I deficiency from 101 families. Pathogenic mtDNA mutations were found in 29 of 101 probands (29%), 21 in MTND subunit genes and 8 in mtDNA tRNA genes. Nuclear gene defects were inferred in 38 of 101 (38%) probands based on cell hybrid studies, mtDNA sequencing or mutation analysis (nuclear gene mutations were identified in 22 probands). Leigh or Leigh-like disease was the most common clinical presentation in both mtDNA and nuclear genetic defects. The median age at onset was higher in mtDNA patients (12 months) than in patients with a nuclear gene defect (3 months). However, considerable overlap existed, with onset varying from 0 to >60 months in both groups. Our findings confirm that pathogenic mtDNA mutations are a significant cause of complex I deficiency in children. In the absence of parental consanguinity, we recommend whole mitochondrial genome sequencing as a key approach to elucidate the underlying molecular genetic abnormality. PMID:21364701

Swalwell, Helen; Kirby, Denise M; Blakely, Emma L; Mitchell, Anna; Salemi, Renato; Sugiana, Canny; Compton, Alison G; Tucker, Elena J; Ke, Bi-Xia; Lamont, Phillipa J; Turnbull, Douglass M; McFarland, Robert; Taylor, Robert W; Thorburn, David R

2011-01-01

55

Demographic, etiological, and histological pulmonary analysis of patients with acute respiratory failure: a study of 19 years of autopsies  

PubMed Central

INTRODUCTION: Acute respiratory failure has been one of the most important causes of death in intensive care units, and certain aspects of its pulmonary pathology are currently unknown. OBJECTIVES: The objective was to describe the demographic data, etiology, and pulmonary histopathological findings of different diseases in the autopsies of patients with acute respiratory failure. METHOD: Autopsies of 4,710 patients with acute respiratory failure from 1990 to 2008 were reviewed, and the following data were obtained: age, sex, and major associated diseases. The pulmonary histopathology was categorized as diffuse alveolar damage, pulmonary edema, alveolar hemorrhage, and lymphoplasmacytic interstitial pneumonia. The odds ratio of the concordance between the major associated diseases and specific autopsy findings was calculated using logistic regression. RESULTS: Bacterial bronchopneumonia was present in 33.9% of the cases and cancer in 28.1%. The pulmonary histopathology showed diffuse alveolar damage in 40.7% (1,917) of the cases. A multivariate analysis showed a significant and powerful association between diffuse alveolar damage and bronchopneumonia, HIV/AIDS, sepsis, and septic shock, between liver cirrhosis and pulmonary embolism, between pulmonary edema and acute myocardial infarction, between dilated cardiomyopathy and cancer, between alveolar hemorrhage and bronchopneumonia and pulmonary embolism, and between lymphoplasmacytic interstitial pneumonia and HIV/AIDS and liver cirrhosis. CONCLUSIONS: Bronchopneumonia was the most common diagnosis in these cases. The most prevalent pulmonary histopathological pattern was diffuse alveolar damage, which was associated with different inflammatory conditions. Further studies are necessary to elucidate the complete pathophysiological mechanisms involved with each disease and the development of acute respiratory failure. PMID:21876973

de Matos Soeiro, Alexandre; Ruppert, Aline D; Canzian, Mauro; Parra, Edwin R; Farhat, Cecilia; Capelozzi, Vera L

2011-01-01

56

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 and similar design make 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; Duncan, Gary

2014-01-01

57

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

58

[The critical role of the nurse in successful non-invasive ventilation in acute respiratory failure].  

PubMed

Non-invasive ventilation is a common therapy for acute respiratory failure. Nurses play an important role in the setting up of this treatment, a time-consuming process, as well as its monitoring. It has been shown that the tolerance of non-invasive ventilation significantly influences the success of this treatment. PMID:22372113

Deprugney, Guylaine; Humbert-Meyer, Géraldine; Kheir, Ayman

2012-01-01

59

Chronic respiratory failure and physical reconditioning: case study of an elderly obese woman  

Microsoft Academic Search

A case is described of a 67 year old obese white woman who had a history of multiple medical problems and who was in chronic respiratory failure but responded poorly to intermittent positive pressure breathing, chest physiotherapy, and supplementary oxygen. She was treated successfully with a 600 k.cal diet and a 26-day physical reconditioning programme. Reconditioning techniques included free and

W. P. Marley; A. J. Barry; J. D. Posner

1979-01-01

60

Inhaled nitric oxide therapy in neonatal hypoxic respiratory failure: insights beyond primary outcomes  

Microsoft Academic Search

The Neonatal Research Network developed and initiated 3 multicenter randomized controlled clinical trials evaluating inhaled nitric oxide therapy. Additional projects evolved from these efforts including basic science research and observational investigations. This article provides a historical prospective of the Network’s investigations related to the diagnosis and management of neonatal hypoxic respiratory failure, especially those related to inhaled nitric oxide therapy.

Gregory M Sokol; Richard A Ehrenkranz

2003-01-01

61

Acute Respiratory Failure as Primary Manifestation of Antineutrophil Cytoplasmic Antibodies-Associated Vasculitis  

PubMed Central

The systemic vasculitides are multifocal diseases characterized by the presence of blood vessel inflammation in multiple organ systems. Their clinical presentation is variable extending from self-limited illness to critical complications including diffuse alveolar hemorrhage and glomerulonephritis. Alveolar hemorrhage is a life-threatening manifestation of pulmonary vasculitis that can rapidly progress into acute respiratory failure requiring ventilatory support. We present the case of a 74-year-old patient admitted to the Intensive Care Unit with severe hypoxic respiratory failure and diffuse alveolar infiltrates in chest imaging that was later diagnosed as antineutrophil cytoplasmic antibodies-associated vasculitis. The report highlights the importance of differentiate between alveolar hemorrhage and acute respiratory distress syndrome of other etiology because alveolar hemorrhage is reversible with prompt initiation of treatment.

Sourla, Evdokia; Bagalas, Vasilis; Tsioulis, Helias; Paspala, Asimina; Akritidou, Sofia; Pataka, Athanasia; Fekete, Katalin; Kioumis, Ioannis P.; Stanopoulos, Ioannis; Pitsiou, Georgia

2014-01-01

62

Pretransplant Lung Function, Respiratory Failure, and Mortality after Stem Cell Transplantation  

PubMed Central

Rationale: The role of pulmonary function before stem cell transplant as a potential risk factor for the development of early post-transplant respiratory failure and mortality is controversial. Methods: We conducted a retrospective analysis of the pretransplant pulmonary function of 2,852 patients who received their transplant between 1990 and 2001. Measurements: Pretransplant FEV1, FVC, total lung capacity (TLC), diffusing capacity of carbon monoxide (DLCO), and the alveolar–arterial oxygen tension difference P(A-a)O2 were measured and assessed for association with development of early respiratory failure and mortality in Cox proportional hazard logistic models. Main Results: In multivariate analyses, progressive decrease of all lung function parameters was associated with a stepwise increase in risk of developing early respiratory failure and mortality when assessed in independent models. On the basis of a significant correlation between FEV1 and FVC (r = 0.81), FEV1 and TLC (r = 0.61), and FVC and TLC (r = 0.80), and a lack of correlation between FEV1 and DLCO, we developed a pretransplant lung function score based on pretransplant FEV1 and DLCO to determine the extent of pulmonary compromise before transplant. Multivariate analysis indicated that higher pretransplant lung function scores are associated with a significant increased risk for developing early respiratory failure (category II hazard ratio [HR], 1.4; category III HR, 2.2; category IV HR, 3.1; p < 0.001) and death (category II HR, 1.2; category III HR, 2.2; category IV HR, 2.7; p < 0.005). Conclusions: These results suggest that not only does compromised pretransplant lung function contribute to the risk for development of early respiratory failure and mortality but this risk may be estimated before transplant by grading the extent of FEV1 and DLCO compromise. PMID:15894602

Parimon, Tanyalak; Madtes, David K.; Au, David H.; Clark, Joan G.; Chien, Jason W.

2005-01-01

63

Rhabdomyolysis associated with acute renal failure in patients with severe acute respiratory syndrome.  

PubMed

An outbreak of severe acute respiratory syndrome (SARS) occurred in Taiwan in 2003. SARS complicated with rhabdomyolysis has rarely been reported. This study reported three cases of rhabdomyolysis developing during the clinical course of SARS. Thirty probable SARS patients were admitted to the isolation wards at Linkou Chang Gung Memorial Hospital between 4 April and 4 June 2003. Thirty patients, including four men and 26 women aged from 12 to 87 years (mean age 40). Eleven (36.7%) patients had respiratory failure and required mechanical ventilation with paralytic therapy; three (10%) patients had rhabdomyolysis complicated with acute renal failure and one received haemodialysis; four (13.3%) patients died. Three cases with rhabdomyolysis all received sedative and paralytic therapy for mechanical ventilation. Haemodialysis was performed on one patient. Two patients died from multiple organ failure, and one patient fully recovered from rhabdomyolysis with acute renal failure. SARS is a serious respiratory illness, and its aetiology is a novel coronavirus. Rhabdomyolysis resulting from SARS virus infection was strongly suspected. Immobilisation under paralytic therapy and steroids may also be important in developing rhabdomyolysis. PMID:16178983

Chen, L-L; Hsu, C-W; Tian, Y-C; Fang, J-T

2005-10-01

64

Indoor woodsmoke pollution causing lower respiratory disease in children.  

PubMed

Suggested aetiological factors were evaluated in 244 consecutive children presenting with lower respiratory disease at Marondera Hospital, Zimbabwe. Data obtained from these children were compared with information obtained from 500 children seen at the local well baby clinic. There were no differences in the prevalence of malnutrition, breast feeding, overcrowding, poor housing conditions and poverty in these two groups of children. A significant association was identified between lower respiratory disease and exposure to atmospheric woodsmoke pollution in young children. Air sampling within the kitchens of 40 children revealed levels of atmospheric pollution far in excess of the WHO recommended exposure limit. Elevated carboxyhaemoglobin concentrations confirmed childhood smoke inhalation. We suggest that in many Third World communities a chemical pneumonitis resulting from the inhalation of noxious constituents of woodsmoke predisposes to lower respiratory disease in children. PMID:2284665

Collings, D A; Sithole, S D; Martin, K S

1990-10-01

65

Intramural tracheal haematoma causing acute respiratory obstruction in a dog.  

PubMed

Respiratory obstruction resulting from a discrete haematoma within the dorsal tracheal membrane was seen in an 11-year-old neutered female greyhound that had been involved in a fight two days earlier. There was no history or evidence of rodenticide toxicity or other coagulopathy, and it is suggested that the tracheal haematoma resulted from trauma. A right third intercostal thoracotomy was performed and this allowed resection of the haematoma from within the dorsal membrane of the cranial thoracic trachea, relieving the obstruction with no subsequent signs of dyspnoea. Intramural haematoma should be considered as a rare differential diagnosis for dogs presenting with acute respiratory obstruction. PMID:16512849

Pink, J J

2006-03-01

66

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

67

Respiratory illness caused by overheating of polyvinyl chloride  

Microsoft Academic Search

On 9 August 1979, 62 (30.8%) of 201 workers and one of 60 management personnel in a polyvinyl chloride (PVC) fabricating plant developed acute upper and lower respiratory irritation, headache, nausea, and fainting. All were taken to hospital; none died. Sixty of the patients were women. Interviews two weeks later with 57 affected and 14 unaffected workers disclosed that illness

B Froneberg; P L Johnson; P J Landrigan

1982-01-01

68

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

69

Cytokine Imbalance in Infants Receiving Extracorporeal Membrane Oxygenation for Respiratory Failure  

Microsoft Academic Search

Background: It is likely that the imbalance between the pro- and anti-inflammatory cytokines will determine the outcome in infants with severe respiratory failure receiving extracorporeal membrane oxygenation (ECMO). Aims: We determined if there was an imbalance between pro- and anti-inflammatory cytokines in serial bronchoalveolar lavage (BAL) fluid obtained from survivors and non-survivors of ECMO. Methods: We therefore measured the cellular

Reinout J. Mildner; Nicholas Taub; Julian R. Vyas; Hillary M. Killer; Richard K. Firmin; David J. Field; Sailesh Kotecha

2005-01-01

70

Extracorporeal life support outcome for 128 pediatric patients with respiratory failure  

Microsoft Academic Search

Purpose: The aim of this study was to describe a single-center experience with pediatric extracorporeal life support (ECLS) and to determine variables predictive of outcome in pediatric patients, both before the institution of ECLS and while on support.Methods: From October 1985 to September 1998 the authors supported 128 children with severe acute hypoxemic respiratory failure (n = 121, Pao2\\/FIO2 ratio

Fresca Swaniker; Srinivas Kolla; Frank Moler; Joseph Custer; Ronald Grams; Robert Bartlett; Ronald Hirschl

2000-01-01

71

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

72

Estimating common cause failure rates for pumps in nuclear reactors  

SciTech Connect

Common cause fault rates are estimated for certain pumps in US commercial nuclear reactors, based on Licensee Event Reports from January 1972 through April 1978. Vesely's binomial failure rate model is used, with the methodology of Atwood (1980, NUREG/CR-1401). Issues discussed include correct classification of reported events as common cause or not, proper grouping of the pumps into common cause systems, outlier detection, and checking the adequacy of the model. Reasons are given for preferring Bayesian to classical methods for this application.

Atwood, C.L.

1980-01-01

73

Lung ultrasound in acute respiratory failure an introduction to the BLUE-protocol.  

PubMed

Critical ultrasound, apparently a recent field, is in fact the outcome of a slow process, initiated since 1946. The lung was traditionally not considered as part of ultrasound, yet we considered its inclusion as a priority in our definition of critical ultrasound. Acute respiratory failure is one of the most distressing situations for the patient. An ultrasound approach of this disorder - the BLUE-protocol allows rapid diagnosis. Its main features will be described. Each kind of respiratory failure provides a particular ultrasound profile. In this difficult setting, initial mistakes are frequent. The BLUE-protocol proposes a step-by-step approach for making accurate diagnosis. By combining three signs with binary answer (anterior lung sliding, anterior lung-rockets), with venous analysis when required, seven profiles are generated, yielding a 90.5% accuracy. This rate is highly enhanced when simple clinical and laboratory data are considered. The BLUE-protocol can be achieved in three minutes, because the use of an intelligent machine, a universal probe, and standardized points allow major time-saving. Lung ultrasound in the critically ill was long available. In a domain where everything must be fast and accurate, the BLUE-protocol can play a major role in the diagnosis of an acute respiratory failure, usually answering immediately to questions where only sophisticated techniques were hitherto used. PMID:19412150

Lichtenstein, D

2009-05-01

74

Subglosso-palatal membrane a rare cause of neonatal respiratory distress: A case report  

PubMed Central

Subglosso-palatal membrane is a rare cause of acute respiratory distress in newborn. Contrary to the earlier reported cases in which immediate splitting or excision of membrane has been described as measure to relief respiratory distress, we managed our case successfully without any emergency surgical procedure. PMID:24741217

Pandey, Vaibhav; Tiwari, Preeti; Tapadar, Jayanto; Gangopadhyay, Ajay Narayan

2014-01-01

75

Hepatic failure caused by plasma cell infiltration in multiple myeloma  

PubMed Central

Although plasma cell infiltration is not rare in autopsy of patients with multiple myeloma (MM), it is very rarely detected in living patients. This is because MM rarely causes significant liver dysfunction that requires further evaluation. A 49-year-old man presented with acute renal failure and was diagnosed with kappa light chain MM stage IIB. Thalidomide and dexamethasone were initiated. The patient developed a continuous increase in bilirubin that led to severe cholestasis. A liver biopsy revealed plasma cell infiltration. He then rapidly progressed to liver failure and died. Treatment options are limited in MM with significant liver dysfunction. Despite new drug therapies in MM, those patients with rapidly progressive liver failure appear to have a dismal outcome. PMID:19399940

Rahhal, Fadi E; Schade, Robert R; Nayak, Asha; Coleman, Teresa A

2009-01-01

76

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

77

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

PubMed

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 × 10(6) 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; Feldmann, Friederike; 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

2013-10-01

78

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

79

Short-term effects of noisy pressure support ventilation in patients with acute hypoxemic respiratory failure  

PubMed Central

Introduction This study aims at comparing the very short-term effects of conventional and noisy (variable) pressure support ventilation (PSV) in mechanically ventilated patients with acute hypoxemic respiratory failure. Methods Thirteen mechanically ventilated patients with acute hypoxemic respiratory failure were enrolled in this monocentric, randomized crossover study. Patients were mechanically ventilated with conventional and noisy PSV, for one hour each, in random sequence. Pressure support was titrated to reach tidal volumes approximately 8 mL/kg in both modes. The level of positive end-expiratory pressure and fraction of inspired oxygen were kept unchanged in both modes. The coefficient of variation of pressure support during noisy PSV was set at 30%. Gas exchange, hemodynamics, lung functional parameters, distribution of ventilation by electrical impedance tomography, breathing patterns and patient-ventilator synchrony were analyzed. Results Noisy PSV was not associated with any adverse event, and was well tolerated by all patients. Gas exchange, hemodynamics, respiratory mechanics and spatial distribution of ventilation did not differ significantly between conventional and noisy PSV. Noisy PSV increased the variability of tidal volume (24.4?±?7.8% vs. 13.7?±?9.1%, P?<0.05) and was associated with a reduced number of asynchrony events compared to conventional PSV (5 (0 to 15)/30 min vs. 10 (1 to 37)/30 min, P?<0.05). Conclusions In the very short term, noisy PSV proved safe and feasible in patients with acute hypoxemic respiratory failure. Compared to conventional PSV, noisy PSV increased the variability of tidal volumes, and was associated with improved patient-ventilator synchrony, at comparable levels of gas exchange. Trial registration ClinicialTrials.gov, NCT00786292 PMID:24172538

2013-01-01

80

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

81

Prothrombotic state in senile patients with acute exacerbations of chronic obstructive pulmonary disease combined with respiratory failure.  

PubMed

The aim of this study was to study the clinical value of prethrombotic state and treatment with low molecular weight heparin (LMWH) in senile patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD) combined with respiratory failure. Hemorheological markers (hematocrit, blood viscosity and plasma viscosity), fibrinogen (FIB), D-dimer and gas analysis were evaluated in 30 senile patients with AECOPD combined with respiratory failure and compared with those in 30 cases without respiratory failure. A total of 30 cases with AECOPD combined with respiratory failure were randomly divided into treatment and control groups. The two groups received conventional treatment. The treatment group also received LMWH injections every 12 h for 6 days and the clinical effect was observed. The levels of FIB, D-dimer, hematocrit, blood viscosity and plasma viscosity were significantly higher in the patients with AECOPD combined with respiratory failure compared with those in the patients without respiratory failure. The plasma D-dimer and FIB levels had significantly positive correlations with the partial pressure of CO2 (PaCO2) and negative correlations with the partial pressure of O2 (PaO2) in the patients with AECOPD combined with respiratory failure. The curative effect was improved in the treatment group, compared with that in the control group without side-effects. However, no significant changes in activated partial thromboplastin time (APTT) and international normalized ratio (INR) were observed between the treatment and control groups. The senile patients with AECOPD combined with respiratory failure suffered from hypercoagulation. Early detection and diagnosis of the prethrombotic state and timely treatment with LMWH may benefit these patients without side-effects. PMID:23596488

Song, Ya-Jun; Zhou, Zhe-Hui; Liu, Yao-Kang; Rao, Shi-Ming; Huang, Ying-Jun

2013-04-01

82

Noninvasive ventilation in hypercapnic acute respiratory failure due to chronic obstructive pulmonary disease vs. other conditions: effectiveness and predictors of failure  

Microsoft Academic Search

Objective: This study compared the effectiveness of non- invasive ventilation (NIV) and the risk factors for NIV failure in hyper- capnic acute respiratory failure (ARF) due to chronic obstructive pulmonary disease (COPD) vs. non- COPD conditions. Design and set- ting: Prospective cohort study in the medical intensive care unit of a uni- versity hospital. Patients and partic- ipants: 111 patients

Jason Phua; Kien Kong; Kang Hoe Lee; Liang Shen; T. K. Lim

2005-01-01

83

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

84

Nontuberculous Mycobacterial Infection Is Associated with Increased Respiratory Failure: A Nationwide Cohort Study  

PubMed Central

Background and Purpose Population study on relationship between nontuberculous mycobacterial (NTM) infection and respiratory failure (RF) is limited. This study evaluated the RF risk, including acute respiratory failure (ARF), chronic respiratory failure (CRF) and ARF on CRF, in patients with NTM infection in Taiwan. Methods We used the National Health Insurance Research Database of Taiwan to identify 3864 newly diagnosed NTM patients (NTM cohort) from 1999 to 2009, and 15456 non-NTM patients (non-NTM cohort), frequency matched by demographic status for comparison. Incidence and hazard of developing RF were measured by the end of 2010. Results The incidence rate of RF was 4.31-fold higher in the NTM cohort than in the non-NTM cohort (44.0 vs.10.2 per 1000 person-years), with an adjusted hazard ratio (HR) of 3.11 (95% CI: 2.73–3.54). The cumulative proportional incidence of RF was 10% higher in the NTM cohort than in the non-NTM cohort (P<0.0001). The RF risk was much greater within 6 months after the diagnosis of NTM infection with a HR of 7.45 (95% CI?=?5.50–10.09). Age-specific comparison showed that the younger NTM patients had a higher HR of RF than the elderly NTM patients (HR: 4.42, 95% CI: 3.28–5.96 vs. HR: 2.52, 95% CI: 2.17–2.92). Comorbidity increased the risk of RF in both cohorts, particularly in those with chronic obstructive pulmonary disease. Conclusion Our study suggests patients with NTM infection are at a high risk of RF. The risk appears much greater soon after patients diagnosed with NTM infection. PMID:24918925

Yeh, Jun-Jun; Wang, Yu-Chiao; Lin, Cheng-Li; Chou, Christine Yi-Ting; Yeh, Ting-Chun; Wu, Bing-Tsang

2014-01-01

85

Gestational diabetes: a strong independent risk factor for severe neonatal respiratory failure after 34 weeks  

Microsoft Academic Search

Purpose  To evaluate if gestational diabetes (GD) exposes neonates delivered after 34 weeks to an increased risk of severe neonatal\\u000a respiratory failure (NRF).\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Data from 3,237 women who delivered after 34 weeks with systematic screening for GD were analyzed. Diagnosis of severe NRF\\u000a required the association of clinical and radiological criteria with a minimum of 24 h of ventilation and admission to neonatal\\u000a intensive

Pauline Vignoles; Catherine Gire; Julien Mancini; Florence Bretelle; Léon Boubli; Eustase Janky; Xavier Carcopino

86

Non-invasive ventilation for acute hypoxemic respiratory failure: intubation rate and risk factors  

PubMed Central

Introduction We assessed rates and predictive factors of non-invasive ventilation (NIV) failure in patients admitted to the intensive care unit (ICU) for non-hypercapnic acute hypoxemic respiratory failure (AHRF). Methods This is an observational cohort study using data prospectively collected over a three-year period in a medical ICU of a university hospital. Results Among 113 patients receiving NIV for AHRF, 82 had acute respiratory distress syndrome (ARDS) and 31 had non-ARDS. Intubation rates significantly differed between ARDS and non-ARDS patients (61% versus 35%, P?=?0.015) and according to clinical severity of ARDS: 31% in mild, 62% in moderate, and 84% in severe ARDS (P?=?0.0016). In-ICU mortality rates were 13% in non-ARDS, and, respectively, 19%, 32% and 32% in mild, moderate and severe ARDS (P?=?0.22). Among patients with moderate ARDS, NIV failure was lower among those having a PaO2/FiO2 >150 mmHg (45% vs. 74%, p?=?0.04). NIV failure was associated with active cancer, shock, moderate/severe ARDS, lower Glasgow coma score and lower positive end-expiratory pressure level at NIV initiation. Among intubated patients, ICU mortality rate was 46% overall and did not differ according to the time to intubation. Conclusions With intubation rates below 35% in non-ARDS and mild ARDS, NIV stands as the first-line approach; NIV may be attempted in ARDS patients with a PaO2/FiO2?>?150. By contrast, 84% of severe ARDS required intubation and NIV did not appear beneficial in this subset of patients. However, the time to intubation had no influence on mortality. PMID:24215648

2013-01-01

87

Time-varying respiratory pattern characterization in chronic heart failure patients and healthy subjects.  

PubMed

Patients with chronic heart failure (CHF) with periodic breathing (PB) and Cheyne-Stokes respiration (CSR) tend to exhibit higher mortality and poor prognosis. This study proposes the characterization of respiratory patterns in CHF patients and healthy subjects using the envelope of the respiratory flow signal, and autoregressive (AR) time-frequency analysis. In time-varying respiratory patterns, the statistical distribution of the AR coefficients, pole locations, and the spectral parameters that characterize the discriminant band are evaluated to identify typical breathing patterns. In order to evaluate the accuracy of this characterization, a feature selection process followed by linear discriminant analysis is applied. 26 CHF patients (8 patients with PB pattern and 18 with non-periodic breathing pattern (nPB)) are studied. The results show an accuracy of 83.9% with the mean of the main pole magnitude and the mean of the total power, when classifying CHF patients versus healthy subjects, and 83.3% for nPB versus healthy subjects. The best result when classifying CHF patients into PB and nPB was an accuracy of 88.9%, using the coefficient of variation of the first AR coefficient and the mean of the total power. PMID:19964092

Garde, Ainara; Giraldo, Beatriz F; Jané, Raimon; Sörnmo, Leif

2009-01-01

88

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

89

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

90

Effect of Laser Arytenoidectomy on Respiratory Stridor Caused by Multiple System Atrophy  

PubMed Central

Respiratory stridor in patients with multiple system atrophy is a complication that occasionally causes nocturnal sudden death. Continuous positive airway pressure (CPAP) therapy has been proposed as an alternative to tracheostomy to treat nocturnal stridor associated with multiple system atrophy. However, some patients cannot tolerate CPAP therapy and experience sleep disturbances, even if the pressure is controlled; also, CPAP therapy can be less effective in patients with a narrow glottic opening during sleep. This report describes the effect of laser arytenoidectomy on respiratory stridor caused by multiple system atrophy. Citation: Chitose S; Kikuchi A; Ikezono K; Umeno H; Nakashima T. Effect of laser arytenoidectomy on respiratory stridor caused by multiple system atrophy. J Clin Sleep Med 2012;8(6):713-715. PMID:23243406

Chitose, Shun-ichi; Kikuchi, Atsushi; Ikezono, Keiko; Umeno, Hirohito; Nakashima, Tadashi

2012-01-01

91

Causes of treatment failure in gestational trophoblastic disease.  

PubMed

Fifty-three (9.8%) of 539 patients with gestational trophoblastic tumors (invasive mole or choriocarcinoma) referred to the John I. Brewer Trophoblastic Disease Center, Northwestern University Medical School, from 1962 to 1986 died. They all had histologically documented choriocarcinoma. The time from the pregnancy event to treatment and the pretreatment human chorionic gonadotropin level were both significantly greater in the 53 patients who died as compared to the 486 who were cured. Seventy percent of fatal cases developed in association with term or preterm pregnancies, abortions or ectopic pregnancies rather than hydatidiform moles. Fifty-one percent of patients who died had brain, liver and/or peritoneal metastases at diagnosis. Ninety-six percent of patients had a Bagshawe score of greater than or equal to 8 (high-risk group): the average score was 13. The most common causes of death were hemorrhage from one or more metastatic sites (42%) and pulmonary insufficiency (31%). Factors primarily responsible for the treatment failures in these patients were: (1) presence of extensive choriocarcinoma at the time of diagnosis, (2) lack of appropriately aggressive initial treatment in high-risk patients, and (3) failure of presently used treatment protocols to control advanced disease. Secondary chemotherapy and radiotherapy to sites other than the brain failed to improve survival. Adjuvant surgical procedures, especially hysterectomy and thoracotomy, may be useful for excising localized, chemotherapy-resistant tumors. PMID:2822922

Lurain, J R

1987-09-01

92

Failure patterns caused by localized rise in pore-fluid overpressure and effective strength of rocks  

E-print Network

Failure patterns caused by localized rise in pore-fluid overpressure and effective strength), Failure patterns caused by localized rise in pore-fluid overpressure and effective strength of rocks of the effective stress field and may promote various failure patterns. The effect of seepage forces caused

93

Enhanced Defenses against Common Cause Failures for an Advanced Auxiliary Feedwater System  

SciTech Connect

The common cause failures of the auxiliary feed water pumps could have significant impacts on the availability of the auxiliary feed water system and plant safety. In order to minimize the common cause failure of the auxiliary feed water pumps, an advanced nuclear power plants should incorporate lessons learned from previous common cause failure events and operating experiences at the exiting nuclear power plants. In this paper, major causes of common cause failures of the auxiliary feed water pumps and potential defenses against them were investigated from historical common cause failure events. Especially, this study focused on common cause failure events due to hardware deficiencies because the root causes of such events can only be eliminated during design and construction stage of an advanced nuclear plant. Finally, suggestions were made for an advanced auxiliary feedwater system with the enhanced defenses against the common cause failures of the auxiliary feedwater pumps. (author)

Jo, Young G. [Southern Nuclear Operating Company, 40 Inverness Center Parkway P.O. Box 1295, Birmingham, Alabama 35201-1295 (United States)

2004-07-01

94

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

95

Acute Liver Failure Caused by Amanita phalloides Poisoning  

PubMed Central

Mushroom poisoning is a relatively rare cause of acute liver failure (ALF). The present paper analyzes the pathogenesis, clinical features, prognostic indicators, and therapeutic strategies of ALF secondary to ingestion of Amanita phalloides, which represents the most common and deadly cause of mushroom poisoning. Liver damage from Amanita phalloides is related to the amanitins, powerful toxins that inhibit RNA polymerase II resulting in a deficient protein synthesis and cell necrosis. After an asymptomatic lag phase, the clinical picture is characterized by gastrointestinal symptoms, followed by the liver and kidney involvement. Amatoxin poisoning may progress into ALF and eventually death if liver transplantation is not performed. The mortality rate after Amanita phalloides poisoning ranges from 10 to 20%. The management of amatoxin poisoning consists of preliminary medical care, supportive measures, detoxification therapies, and orthotopic liver transplantation. The clinical efficacy of any modality of treatment is difficult to demonstrate since randomized, controlled clinical trials have not been reported. The use of extracorporeal liver assist devices as well as auxiliary liver transplantation may represent additional therapeutic options. PMID:22811920

Santi, Luca; Maggioli, Caterina; Mastroroberto, Marianna; Tufoni, Manuel; Napoli, Lucia; Caraceni, Paolo

2012-01-01

96

Acute Liver Failure Caused by Amanita phalloides Poisoning.  

PubMed

Mushroom poisoning is a relatively rare cause of acute liver failure (ALF). The present paper analyzes the pathogenesis, clinical features, prognostic indicators, and therapeutic strategies of ALF secondary to ingestion of Amanita phalloides, which represents the most common and deadly cause of mushroom poisoning. Liver damage from Amanita phalloides is related to the amanitins, powerful toxins that inhibit RNA polymerase II resulting in a deficient protein synthesis and cell necrosis. After an asymptomatic lag phase, the clinical picture is characterized by gastrointestinal symptoms, followed by the liver and kidney involvement. Amatoxin poisoning may progress into ALF and eventually death if liver transplantation is not performed. The mortality rate after Amanita phalloides poisoning ranges from 10 to 20%. The management of amatoxin poisoning consists of preliminary medical care, supportive measures, detoxification therapies, and orthotopic liver transplantation. The clinical efficacy of any modality of treatment is difficult to demonstrate since randomized, controlled clinical trials have not been reported. The use of extracorporeal liver assist devices as well as auxiliary liver transplantation may represent additional therapeutic options. PMID:22811920

Santi, Luca; Maggioli, Caterina; Mastroroberto, Marianna; Tufoni, Manuel; Napoli, Lucia; Caraceni, Paolo

2012-01-01

97

Eventration of diaphragm with dextrocardia and type 2 respiratory failure: A rare entity  

PubMed Central

Eventration of the diaphragm is a rare condition where the muscle is permanently elevated, but retains its continuity and attachments to costal margin. In this condition, all or part of the diaphragm is largely composed of fibrous tissue with a few or no interspersed muscle fibers. It can be complete or partial. It is seldom symptomatic and often requires no treatment. We present a 70-year-old male who came with progressive breathlessness and was admitted with type 2 respiratory failure, and on evaluation was found to have complete eventration of the left diaphragm with herniation of colon and stomach in the left chest with dextrocardia. Aim of reporting this rare case is to highlight the importance of history taking, good physical examination, and imaging in the diagnosis of diaphragmatic eventration.

Mir, Mohmad Hussain; Arshad, Faheem; Bagdadi, Farhana Siraj; Nasir, Syed Aejaz; Hajni, Mubashir Rashid

2014-01-01

98

A Diverse Group of Previously Unrecognized Human Rhinoviruses Are Common Causes of Respiratory Illnesses in Infants  

Microsoft Academic Search

BackgroundHuman rhinoviruses (HRVs) are the most prevalent human pathogens, and consist of 101 serotypes that are classified into groups A and B according to sequence variations. HRV infections cause a wide spectrum of clinical outcomes ranging from asymptomatic infection to severe lower respiratory symptoms. Defining the role of specific strains in various HRV illnesses has been difficult because traditional serology,

Wai-Ming Lee; Christin Kiesner; Tressa Pappas; Iris Lee; Kris Grindle; Tuomas Jartti; Bogdan Jakiela; Robert F. Lemanske; Peter A. Shult; James E. Gern; Maurizio Del Poeta

2007-01-01

99

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

100

Cheyne-Stokes respiration in patients with heart failure: prevalence, causes, consequences and treatments.  

PubMed

Cheyne-Stokes respiration (CSR) is characterized by a pattern of cyclic oscillations of tidal volume and respiratory rate with periods of hyperpnea alternating with hypopnea or apnea in patients with heart failure. CSR harms the failing heart through intermittent hypoxia brought about by apnea and hypopnea and recurrent sympathetic surges. CSR impairs the quality of life and increases cardiac mortality in patients with heart failure. Thus, CSR should actively be pursued in patients with severe heart failure. When CSR persists despite optimal therapy of heart failure, noninvasive adaptive servoventilation is currently the most promising treatment. PMID:22025128

Brack, Thomas; Randerath, Winfried; Bloch, Konrad E

2012-01-01

101

Epidemiology of respiratory infections caused by atypical bacteria in two Kenyan refugee camps.  

PubMed

Chlamydia pneumoniae, Mycoplasma pneumoniae, and Legionella spp. are common causes of atypical pneumonia; however, data about these atypical pathogens are limited in the refugee setting. Paired nasopharyngeal and oropharyngeal specimens were collected from patients with respiratory illness presenting to healthcare centers in two refugee camps in Kenya. The specimens were tested for C. pneumoniae, M. pneumoniae, and Legionella spp. as well as eight respiratory viruses. Atypical pathogens were detected in 5.5% of the specimens of which 54% were co-infected with at least one of the eight viruses tested. Patients positive for atypical bacteria co-infected with virus were significantly more likely to have severe acute respiratory illness than patients infected with only atypical bacteria (P = 0.04). While the percentage of atypical pathogens identified was lower than expected, we found a significant relationship between atypical bacterial-viral co-infection and severity of disease in this refugee population. PMID:21701900

Kim, Curi; Nyoka, Raymond; Ahmed, Jamal A; Winchell, Jonas M; Mitchell, Stephanie L; Kariuki Njenga, M; Auko, Erick; Burton, Wagacha; Breiman, Robert F; Eidex, Rachel B

2012-02-01

102

OXIDATIVE STRESS AND ANTIOXIDANT STATUS IN BRONCHOALVEOLAR LAVAGE FLUID, PLASMA AND ERYTHROCYTE OF CRITICALLY MIXED ILL WITH RESPIRATORY FAILURE  

Microsoft Academic Search

Aim: Increased oxidative stress is a significant part of pathogenesis of various lung diseases. In this trial, it is aimed to determine the role of oxidative stress in patients receiving mechanical ventilation for respiratory failure (RF). Methods: The oxidative stress was evaluated by determining plasma, bronchial fluid and erythrocyte levels of malondialdehyde (MDA), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), ascorbic

Elif Demirkapi

103

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

104

Organizing pneumonia in patients with severe respiratory failure due to novel A (H1N1) influenza  

PubMed Central

The authors describe two cases that developed organizing pneumonia (OP) associated with novel influenza A(H1N1) virus. These patients were admitted to intensive care unit (ICU) because of severe respiratory failure. After initial clinical improvement, both patients worsened their condition during their second week of ICU stay, presenting fever, increasing in inflammatory parameters and worsening in oxygen exchange and respiratory mechanics. Chest x-rays and computed tomographies showed an increment on lung infiltrates, given by areas of consolidation and ground glass opacification. Although broad-spectrum antibiotics were administered, patients showed no improvement. All cultures, including bronchoalveolar lavage samples, were negative. In both cases, an open lung biopsy was performed, and histopathological examination of the specimen was compatible with OP. Both patients were successfully treated with high-dose corticoids. The aim of this report is to alert about the possibility of OP associated with novel influenza virus in patients with severe respiratory failure. PMID:22767562

Cornejo, Rodrigo; Llanos, Osvaldo; Fernandez, Cristina; Carlos Diaz, Juan; Cardemil, Gonzalo; Salguero, Jorge; Luengo, Cecilia; Tobar, Eduardo; Romero, Carlos; Galvez, Luis Ricardo

2010-01-01

105

CITED2 mutations potentially cause idiopathic premature ovarian failure.  

PubMed

Anomalies in gonadal development in a mouse knockout model of Cited2 have been recently described. In Cited2(-/-) female gonads, an ectopic cell migration was observed and the female program of sex determination was transiently delayed. We hypothesize that, in humans, this temporary inhibition of genes should be sufficient to provoke a developmental impairment of the female gonads, conducive to premature ovarian failure (POF). To establish whether CITED2 mutations are a common cause of the disease, we performed a mutational analysis of this gene in a panel of patients with POF and in a group of control women with normal fertility. We amplified and directly sequenced the complete open reading frame of CITED2 in 139 patients with POF and 290 controls. This study revealed 5 synonymous and 3 nonsynonymous variants. Among these, 7 are novel. The nonsynonymous variant c.604C>A (p.Pro202Thr) was found uniquely in 1 woman from the POF group. In silico analysis of this mutation indicated a potential deleterious effect. We conclude that mutations in CITED2 may be involved in POF pathogenesis. PMID:22709740

Fonseca, Dora Janeth; Ojeda, Diego; Lakhal, Besma; Braham, Rim; Eggers, Stefanie; Turbitt, Erin; White, Stefan; Grover, Sonia; Warne, Garry; Zacharin, Margaret; Nevin Lam, Alexandra; Landolsi, Hanène; Elghezal, Hatem; Saâd, Ali; Restrepo, Carlos Martín; Fellous, Marc; Sinclair, Andrew; Koopman, Peter; Laissue, Paul

2012-11-01

106

The application of esophageal pressure measurement in patients with respiratory failure.  

PubMed

This report summarizes current physiological and technical knowledge on esophageal pressure (Pes) measurements in patients receiving mechanical ventilation. The respiratory changes in Pes are representative of changes in pleural pressure. The difference between airway pressure (Paw) and Pes is a valid estimate of transpulmonary pressure. Pes helps determine what fraction of Paw is applied to overcome lung and chest wall elastance. Pes is usually measured via a catheter with an air-filled thin-walled latex balloon inserted nasally or orally. To validate Pes measurement, a dynamic occlusion test measures the ratio of change in Pes to change in Paw during inspiratory efforts against a closed airway. A ratio close to unity indicates that the system provides a valid measurement. Provided transpulmonary pressure is the lung-distending pressure, and that chest wall elastance may vary among individuals, a physiologically based ventilator strategy should take the transpulmonary pressure into account. For monitoring purposes, clinicians rely mostly on Paw and flow waveforms. However, these measurements may mask profound patient-ventilator asynchrony and do not allow respiratory muscle effort assessment. Pes also permits the measurement of transmural vascular pressures during both passive and active breathing. Pes measurements have enhanced our understanding of the pathophysiology of acute lung injury, patient-ventilator interaction, and weaning failure. The use of Pes for positive end-expiratory pressure titration may help improve oxygenation and compliance. Pes measurements make it feasible to individualize the level of muscle effort during mechanical ventilation and weaning. The time is now right to apply the knowledge obtained with Pes to improve the management of critically ill and ventilator-dependent patients. PMID:24467647

Akoumianaki, Evangelia; Maggiore, Salvatore M; Valenza, Franco; Bellani, Giacomo; Jubran, Amal; Loring, Stephen H; Pelosi, Paolo; Talmor, Daniel; Grasso, Salvatore; Chiumello, Davide; Guérin, Claude; Patroniti, Nicolo; Ranieri, V Marco; Gattinoni, Luciano; Nava, Stefano; Terragni, Pietro-Paolo; Pesenti, Antonio; Tobin, Martin; Mancebo, Jordi; Brochard, Laurent

2014-03-01

107

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

108

Fatal respiratory failure during a "technical" rebreather dive at extreme pressure.  

PubMed

A diving fatality at the extreme depth of 264 m fresh water is described. The diver was equipped with an underwater video camera which recorded events leading to his death. These events corroborated predictions about respiratory complications at extreme pressure made by early researchers. Review of the video and relevant literature resulted in the following physiological interpretation: an increase in respired gas density during descent caused a progressive increase in resistance to flow in both the airways and the breathing circuit. Initially, this was associated with a shift to ventilation at higher lung volumes, a relative degree of hypoventilation, and mild permissive hypercapnia. The promotion of turbulent airway flow by increasing gas density resulted in effort-independent expiratory flow at lower flow rates than usual. The consequent inability to match ventilation to the demands of physical work at the bottom precipitated a spiraling crisis of dyspnea, increasing PaCO2, and wasted respiratory effort, thus producing more CO2. Extreme hypercapnia eventually led to unconsciousness. This tragic case provides a timely and salient lesson to a growing population of deep "technical" divers that there are physiological limitations that must be understood and considered when planning extreme dives. PMID:17310877

Mitchell, Simon J; Cronjé, Frans J; Meintjes, W A Jack; Britz, Hermie C

2007-02-01

109

[Congenital pulmonary lymphangiectasis: an unusual cause of respiratory distress in neonates].  

PubMed

Congenital pulmonary lymphangiectasis (CPL) is a rare condition in neonates characterized by abnormal dilatation of the lymphatics draining the interstitial and subpleural spaces of the lungs. Diagnosis is difficult in the neonatal period because respiratory features and radiological findings are not specific of the disease. Definitive diagnosis of CPL can be made only by pathologic examinations. We report a case of a male near-term neonate presenting with severe respiratory distress at birth. The initial chest X-ray showed frosted glass-like infiltrates with air bronchogram suggesting a maternofetal infection or respiratory distress syndrome. The infant required mechanical ventilation and chest tube insertion for right then bilateral pneumothorax. The child died 15 days later in spite of optimal high-frequency ventilation, bilateral pneumothorax drainage, and hemodynamic support. Autopsy revealed features consistent with the diagnosis of CPL. Although CPL is very rare, we should be aware that it is a possible cause of severe unexplained respiratory distress in neonates. PMID:22381667

Nouri-Merchaoui, S; Mahdhaoui, N; Yacoubi, M-T; Seboui, H

2012-04-01

110

Respiratory sound energy and its distribution patterns following clinical improvement of congestive heart failure: a pilot study  

PubMed Central

Background Although congestive heart failure (CHF) patients typically present with abnormal auscultatory findings on lung examination, respiratory sounds are not normally subjected to additional analysis. The aim of this pilot study was to examine respiratory sound patterns of CHF patients using acoustic-based imaging technology. Lung vibration energy was examined during acute exacerbation and after clinical improvement. Methods Respiratory sounds throughout the respiratory cycle were captured using an acoustic-based imaging technique. Twenty-three consecutive CHF patients were imaged at the time of presentation to the emergency department and after clinical improvement. Digital images were created (a larger image represents more homogeneously distributed vibration energy of respiratory sound). Geographical area of the images and respiratory sound patterns were quantitatively analyzed. Data from the CHF patients were also compared to healthy volunteers. Results The median (interquartile range) geographical areas of the vibration energy image of acute CHF patients without and with radiographically evident pulmonary edema were 66.9 (9.0) and 64.1(9.0) kilo-pixels, respectively (p < 0.05). After clinical improvement, the geographical area of the vibration energy image of CHF patients without and with radiographically evident pulmonary edema were increased by 18 ± 15% (p < 0.05) and 25 ± 16% (p < 0.05), respectively. Conclusions With clinical improvement of acute CHF exacerbations, there was more homogenous distribution of lung vibration energy, as demonstrated by the increased geographical area of the vibration energy image. PMID:20078862

2010-01-01

111

Cardiorenal Syndrome Caused by Heart Failure with Preserved Ejection Fraction  

PubMed Central

Since cardiorenal dysfunction is usually secondary to multiple factors acting in concert (and not only reduced cardiac output) in the present paper we are going to focus on the interrelationship between heart failure with normal ejection fraction and the development of cardiorenal syndrome. The coexistence of renal impairment in heart failure with preserved ejection fraction (CRS type 2 and 4) is common especially in older females with hypertension and/or diabetes. It can be hypothesized that the incidence of this disease association is growing, while clinical trials enrolling these patients are still lacking. The main mechanisms thought to be involved in the pathophysiology of this condition are represented by the increase of intra-abdominal and central venous pressure and the activation of the renin-angiotensin system. Differently from CRS in heart failure with reduced ejection fraction, the involvement of the kidney may be under-diagnosed in patients with heart failure and preserved ejection fraction and the optimal therapeutic strategy in this condition, though challenging, is far to be completely elucidated. Further studies are needed to assess the best therapeutic regimen in patients with renal dysfunction (and worsening) and heart failure and preserved ejection fraction. PMID:21331316

Lazzeri, Chiara; Valente, Serafina; Tarquini, Roberto; Gensini, Gian Franco

2011-01-01

112

California Fault Lines: Understanding the Causes and Impact of Network Failures  

E-print Network

demonstrate a methodology for reconstructing historical network failure events inside of an autonomous systemCalifornia Fault Lines: Understanding the Causes and Impact of Network Failures Daniel Turner factors affecting end-to-end service availability, net- work component failure is perhaps the least well

113

Mixed Acid-Base Disorders, Hydroelectrolyte Imbalance and Lactate Production in Hypercapnic Respiratory Failure: The Role of Noninvasive Ventilation  

PubMed Central

Background Hypercapnic Chronic Obstructive Pulmonary Disease (COPD) exacerbation in patients with comorbidities and multidrug therapy is complicated by mixed acid-base, hydro-electrolyte and lactate disorders. Aim of this study was to determine the relationships of these disorders with the requirement for and duration of noninvasive ventilation (NIV) when treating hypercapnic respiratory failure. Methods Sixty-seven consecutive patients who were hospitalized for hypercapnic COPD exacerbation had their clinical condition, respiratory function, blood chemistry, arterial blood gases, blood lactate and volemic state assessed. Heart and respiratory rates, pH, PaO2 and PaCO2 and blood lactate were checked at the 1st, 2nd, 6th and 24th hours after starting NIV. Results Nine patients were transferred to the intensive care unit. NIV was performed in 11/17 (64.7%) mixed respiratory acidosis–metabolic alkalosis, 10/36 (27.8%) respiratory acidosis and 3/5 (60%) mixed respiratory-metabolic acidosis patients (p?=?0.026), with durations of 45.1±9.8, 36.2±8.9 and 53.3±4.1 hours, respectively (p?=?0.016). The duration of ventilation was associated with higher blood lactate (p<0.001), lower pH (p?=?0.016), lower serum sodium (p?=?0.014) and lower chloride (p?=?0.038). Hyponatremia without hypervolemic hypochloremia occurred in 11 respiratory acidosis patients. Hypovolemic hyponatremia with hypochloremia and hypokalemia occurred in 10 mixed respiratory acidosis–metabolic alkalosis patients, and euvolemic hypochloremia occurred in the other 7 patients with this mixed acid-base disorder. Conclusions Mixed acid-base and lactate disorders during hypercapnic COPD exacerbations predict the need for and longer duration of NIV. The combination of mixed acid-base disorders and hydro-electrolyte disturbances should be further investigated. PMID:22539963

Terzano, Claudio; Di Stefano, Fabio; Conti, Vittoria; Di Nicola, Marta; Paone, Gregorino; Petroianni, Angelo; Ricci, Alberto

2012-01-01

114

Tests find hammering, fluid cutting, erosion cause float shoe failures  

SciTech Connect

The results of a systematic test program to evaluate float equipment performance are presented. The testing has destroyed, over an eightmonth period, 160 float valves, float shoes and float collars. A new float valve design with greater resistance to failure has been developed as a result of the testing. New float collars and float shoes are expected to provide the operator with a failure rate of less than 1 1/2% when used within design limits and under normal cementing conditions. Further testing objectives include: extension of operating temperature limits to include deep well and geothermal conditions, and evaluation of the effects of more abrasive mud and cement systems.

Stringfellow, B.

1985-01-21

115

Highly Pathogenic Avian Influenza Virus H7N7 Isolated From a Fatal Human Case Causes Respiratory Disease in Cats but Does Not Spread Systemically  

PubMed Central

Highly pathogenic avian influenza viruses (HPAIV) of the H5 and H7 subtypes primarily infect poultry but are occasionally transmitted to humans and other mammalian species, often causing severe disease. Previously we have shown that HPAIV H5N1 causes severe systemic disease in cats. In this study, we investigated whether HPAIV H7N7 isolated from a fatal human case is also able to cause disease in cats. Additionally, we compared the cell tropism of both viruses by immunohistochemistry and virus histochemistry. Three domestic cats were inoculated intratracheally with HPAIV H7N7. Virus excretion was restricted to the pharynx. At necropsy, 7 days post inoculation, lesions were restricted to the respiratory tract in all cats. Lesions consisted of diffuse alveolar damage and colocalized with virus antigen expression in type II pneumocytes and nonciliated bronchiolar cells. The attachment patterns of HPAIV H7N7 and H5N1 were similar: both viruses attached to nonciliated bronchiolar epithelial cells, type II pneumocytes, as well as alveolar macrophages. These data show for the first time that a non-H5 HPAIV is able to infect and cause respiratory disease in cats. The failure of HPAIV H7N7 to spread beyond the respiratory tract was not explained by differences in cell tropism compared to HPAIV H5N1. These findings suggest that HPAIV H5N1 possesses other characteristics that allow it to cause systemic disease in both humans and cats. PMID:20847292

van Riel, Debby; Rimmelzwaan, Guus F.; van Amerongen, Geert; Osterhaus, Albert D.M.E.; Kuiken, Thijs

2010-01-01

116

Current knowledge on Chlamydia pneumoniae , strain TWAR, an important cause of pneumonia and other acute respiratory diseases  

Microsoft Academic Search

This article reviews current knowledge ofChlamydia pneumoniae strain TWAR, a newly recognizedChlamydia organism that causes acute respiratory infection, especially atypical pneumonia. Information is included on the microbiology, classification and laboratory diagnosis of the organism. Details of a series of studies of both endemic and epidemic respiratory infections are reviewed to present information on both the clinical and epidemiological characteristics of

J. T. Grayston; S. P. Wang; C. C. Kuo; L. A. Campbell

1989-01-01

117

Inhaled ?-agonist therapy and respiratory muscle fatigue as under-recognised causes of lactic acidosis.  

PubMed

A 49-year-old man with chronic obstructive pulmonary disease (COPD) presented with significant tachypnoea, fevers, productive cough and increased work of breathing for the previous 4 days. Laboratory data showed elevated lactate of 3.2 mEq/L. Continuous inhaled ipratropium and albuterol nebuliser treatments were administered. Lactate levels increased to 5.5 and 3.9 mEq/L, at 6 and 12 h, respectively. No infectious source was found and the lactic acidosis cleared as the patient improved. The lactic acidosis was determined to be secondary to respiratory muscle fatigue and inhaled ?-agonist therapy, two under-recognised causes of lactic acidosis in patients presenting with respiratory distress. Lactic acidosis is commonly used as a clinical marker for sepsis and shock, but in the absence of tissue hypoperfusion and severe hypoxia, alternative aetiologies for elevated levels should be sought to avoid unnecessary and potentially harmful medical interventions. PMID:24127377

Lau, Emily; Mazer, Jeffrey; Carino, Gerardo

2013-01-01

118

Tests find hammering, fluid cutting, erosion cause float shoe failures  

Microsoft Academic Search

The results of a systematic test program to evaluate float equipment performance are presented. The testing has destroyed, over an eightmonth period, 160 float valves, float shoes and float collars. A new float valve design with greater resistance to failure has been developed as a result of the testing. New float collars and float shoes are expected to provide the

Stringfellow

1985-01-01

119

Dilated Cardiomyopathies as a Cause of Congestive Heart Failure  

Microsoft Academic Search

Definition and Classification: Cardiomyopathies are disorders affecting the heart muscle that frequently result in congestive heart failure. Five major forms are recognized: dilated, hypertrophic, restrictive, right ventricular, and nonclassifiable cardiomyopathies with distinct hemodynamic properties. Furthermore, the new WHO\\/WHF definition also comprises inflammatory cardiomyopathy, defined as myocarditis in association with cardiac dysfunction. Idiopathic, autoimmune, and infectious forms of inflammatory cardiomyopathy were

Bernhard Maisch; Arsen D. Risti?; Günter Hufnagel; Reinhard Funck; Peter Alter; Daniela Tontsch; Sabine Pankuweit

2002-01-01

120

Causes and mechanisms of massive pillar failure in a southern West Virginia coal mine  

Microsoft Academic Search

This paper deals with the causes and mechanisms of pillar failure in a southern West Virginia coal mine. Conclusions are based on in-mine observations and analysis of mining methods, eyewitness accounts of the sequence of events, topographic and geologic conditions, and mechanical properties of mine roof, coal, and floor. The study indicated that massive pillar failure was caused by the

A. W. Khair; S. S. Peng

1985-01-01

121

Causes and mechanisms of massive pillar failure in a southwestern West Virginia coal mine  

Microsoft Academic Search

The paper examines the causes and mechanisms of a pillar failure in a W. Virginia coal mine on the basis of topographic and geologic conditions, mechanical properties of mine roof, coal and floor, together with eye-witness accounts. The study indicated that massive pillar failure was caused by the collapse of the mine roof due to the combined effects of high

A. W. Khair; S. S. Peng

1985-01-01

122

Causes and mechanisms of massive pillar failure in a southern West Virginia coal mine  

Microsoft Academic Search

This paper deals with the causes and mechanisms of pillar failure in a southern West Virginia coal mine. The conclusions are based on in-mine observations and analysis of mining methods, eyewitness account of the sequence of events, topographic and geologic conditions, and mechanical properties of mine roof, coal, and floor. The study indicated that massive pillar failure was caused by

A. W. Khair; S. S. Peng

1983-01-01

123

Lung injury and renal failure caused by potassium cyanide poisoning  

PubMed Central

Our objective is to show that cyanide poisoning presents with various symptoms, and that recognition of these symptoms is required for appropriate management of the condition. A 54-year-old man drank about 2.5 times the normal fatal dose of potassium cyanide in a suicide attempt. On arrival at hospital (day 0), the patient was restless and in a state of shock. We administered 100% oxygen and performed immediate detoxification. Ground-glass attenuation appeared on the evening of day 1 and lung injury due to cyanide was suspected. Inflammation improved slowly with the use of artificial ventilation, but anuria continued and sudden renal failure occurred on day 2. We suspected that renal failure was due to cyanide metabolites, and continuous haemodiafiltration (CHDF) was initiated. Renal function improved slowly and CHDF was discontinued on the sixth day. Symptoms of cyanide poisoning may include lung injury and renal damage, in addition to disturbance of consciousness. PMID:22162737

Matsuoka, Yoshinori; Yasuda, Mitsuhiro; Hashizume, Makoto

2009-01-01

124

Total Liquid Ventilation Provides Superior Respiratory Support to Conventional Mechanical Ventilation in a Large Animal Model of Severe Respiratory Failure  

PubMed Central

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 mmHg, 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

125

Phenotyping community-acquired pneumonia according to the presence of acute respiratory failure and severe sepsis  

PubMed Central

Background Acute respiratory failure (ARF) and severe sepsis (SS) are possible complications in patients with community-acquired pneumonia (CAP). The aim of the study was to evaluate prevalence, characteristics, risk factors and impact on mortality of hospitalized patients with CAP according to the presence of ARF and SS on admission. Methods This was a multicenter, observational, prospective study of consecutive CAP patients admitted to three hospitals in Italy, Spain, and Scotland between 2008 and 2010. Three groups of patients were identified: those with neither ARF nor SS (Group A), those with only ARF (Group B) and those with both ARF and SS (Group C) on admission. Results Among the 2,145 patients enrolled, 45% belonged to Group A, 36% to Group B and 20% to Group C. Patients in Group C were more severe than patients in Group B. Isolated ARF was correlated with age (p?

2014-01-01

126

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

127

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

128

Outcomes of stem cell transplant patients with acute respiratory failure requiring mechanical ventilation in the United States.  

PubMed

SCT indications and procedures are increasing worldwide. We sought to estimate the prevalence of acute respiratory failure (ARF) of any cause in hospitalized SCT patients, and assess the impact of invasive mechanical ventilation (IMV) on outcomes. We hypothesize that duration of IMV in such patients is an independent predictor of higher mortality. We performed a retrospective analysis of the largest all-payer hospitalization data set in the United States, Nationwide In-patient Sample for years 2004-2010. Of the 101?462 SCT hospitalizations, 6074 (6%) developed ARF and were the final cohort. Type of SCT with ARF included autologous 1987 (32.7%), allogeneic 3467 (57.1%) and cord blood 655 (10.8%). Duration of IMV included <96?h (17.1%) and ?96?h (41.1%). Overall in-hospital mortality (IHM) was 50.6% (3075). Predictors of IHM were IMV <96?h (odds ratio=3.42 (2.44-4.79), P<0.0001) or IMV ?96?h (OR=4.61 (3.17-6.70), P<0.0001). Type of SCT, comorbid burden, gender, hospital-teaching status/bed size or insurance did not influence IHM. IMV ?96?h was associated with higher hospital charges (mean $762?515, 95% estimate 0.3991 (0.3123-0.4859), increase of $304?474, P<0.0001) and higher length of stay (mean 61.5 days, 95% estimate 0.2198 (0.1531-0.2866), increase of 13 days, P<0.0001). In conclusion, ARF in hospitalized SCT patients is not an uncommon occurrence and is associated with 50% mortality. Duration of IMV (?96?h) was an independent predictor of higher mortality rates. Hospital resource utilization was significant. PMID:25111514

Allareddy, V; Roy, A; Rampa, S; Lee, M K; Nalliah, R P; Allareddy, V; Rotta, A T

2014-10-01

129

Acute respiratory infections are the leading cause of death in children in developing countries.  

PubMed

A paper by Hazlett et al. is of particular importance because it addresses the question of the role of acute respiratory infections (ARI) as a cause of morbidity and especially mortality in 3rd world children. Diarrheal disease and malnutrition are generally thought to be the major killers of these children, and until recently little attention was paid to ARI. Recent data suggest that ARI are more important than realized previously and almost certainly are the leading cause of death in children in developing countries. It is estimated that each year more than 15 million children less than 5 years old die, obviously most in socially and economically deprived countries. Since death usually is due to a combination of social, economic, and medical factors, it is impossible to obtain precise data on the causes of death. It has been estimated that 5 million of the deaths are due to diarrhea, over 3 million due to pneumonia, 2 million to measles, 1.5 million to pertussis, 1 million to tetanus, and the other 2.5 million or less to other causes. Since pertussis is an acute respiratory infection and measles deaths frequently are due to infections of the respiratory tract, it is becoming clear that ARI are associated with more deaths than any other single cause. The significance of this is emphasized when the mortality rates from ARI in developed and underdeveloped nations are compared. Depending on the countries compared, age group, and other factors, increases of 5-10-fold have been reported. These factors raise the question of why respiratory infections are so lethal for 3rd world children. The severity of pneumonia, which is the cause of most ARI deaths, seems to be the big difference. Data are accumulating which show that bacterial infections are associated with the majority of severe infections and "Streptococcus pneumoniae" and "Haemophilus influenzae," infrequent causes of pneumonia in developed world children, are the microorganisms incriminated in a large proportion of cases. The increase in severity of ARI in 3rd world children has been associated, at least in port, with malnutrition, diarrheal diseases, an increased parasite load, and more recently with air pollution. Crowding and other factors associated with poverty doubtless also play a role. How these various factors contribute to increased severity and lethality is not well understood. The increasing recognition of the important role played by ARI as causes of mortality in 3rd world children is encouraging. The UN International Children's Emergency Fund (UNICEF) has joined the World Health Organization in the battle against ARI in developing countries, and the 2 organizations recently issued a joint statement on the subject in which they pledged to collaborate to integrate an ARI component into the primary health care program. PMID:3946732

Denny, F W; Loda, F A

1986-01-01

130

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.

131

The binomial failure rate common-cause model with WinBUGS  

Microsoft Academic Search

The binomial failure rate (BFR) common-cause model was introduced in the 1970s, but has not been used much recently. It turns out to be very easy to use with WinBUGS, a free, widely used Markov chain Monte Carlo (MCMC) program for Bayesian estimation. This fact recommends it in situations when failure data are available, especially when few failures have been

Corwin L. Atwood; Dana L. Kelly

2009-01-01

132

Bucket wheel failure caused by residual stresses in welded joints  

Microsoft Academic Search

Cracks in the welded joints on the bucket wheel (BW) body of the bucket wheel excavator (BWE) SRs 1300 were discovered after merely 1800h of operation. Investigations are carried out in order to detect the causes of cracks occurrence and thus prevent possible heavy damages to the machine.Working stresses in the BW body are defined by using FEM. Methods of

Miodrag Arsi?; Sr?an Bošnjak; Nenad Zrni?; Aleksandar Sedmak; Nebojša Gnjatovi?

2011-01-01

133

The Effect of Respiratory Scoring on the Diagnosis and Classification of Sleep Disordered Breathing in Chronic Heart Failure  

PubMed Central

Study Objectives: To evaluate the effect of respiratory scoring criteria on diagnosis and classification of sleep disordered breathing (SDB) in chronic heart failure (CHF). Design: Cross-sectional observational study. Setting: Heart failure and general cardiology clinics at two London hospitals. Patients or Participants: One hundred eighty stable patients with CHF and a median age of 69.6 y, 86% male. Interventions: SDB was diagnosed by polysomnography. The apnea-hypopnea index (AHI) was initially scored using a conservative hypopnea definition of a ? 50% decrease in nasal airflow with a ? 4% oxygen desaturation. The AHI was rescored with hypopnea defined according to the American Academy of Sleep Medicine (AASM) alternative scoring rule, requiring an associated ? 3% oxygen desaturation or arousal. SDB was defined as AHI ? 15/h. Diagnosis and classification of SDB as obstructive sleep apnea (OSA) or central sleep apnea (CSA) with each rule were compared. The effect of mixed apneas on classification of SDB as CSA or OSA was also investigated. Measurements and Results: Median AHI increased from 9.3/h to 13.8/h (median difference 4.6/h) when the AASM alternative rule was used to score hypopneas. SDB prevalence increased from 29% to 46% with the alternative scoring rule (P < 0.001). Classification of SDB as OSA or CSA was not significantly altered by hypopnea scoring rules or the categorization of mixed apneas. Conclusion: Hypopnea scoring rules can significantly influence the apnea-hypopnea index and diagnosis of sleep disordered breathing in chronic heart failure but do not alter the classification as obstructive sleep apnea or central sleep apnea. Standardization of hypopnea scoring rules is important to ensure consistency in diagnosis of sleep disordered breathing in chronic heart failure patients. Citation: Ward NR; Roldao V; Cowie MR; Rosen SD; McDonagh TA; Simonds AK; Morrell MJ. The effect of respiratory scoring on the diagnosis and classification of sleep disordered breathing in chronic heart failure. SLEEP 2013;36(9):1341-1348. PMID:23997367

Ward, Neil R.; Roldao, Vitor; Cowie, Martin R.; Rosen, Stuart D.; McDonagh, Theresa A.; Simonds, Anita K.; Morrell, Mary J.

2013-01-01

134

Sonographs of submarine sediment failure caused by the 1980 earthquake off northern California  

NASA Astrophysics Data System (ADS)

In 1980, a large earthquake caused extensive sediment failure on the shallow continental shelf off the Klamath River in northern California. Side-scan sonography was used to complement detailed geophysical profiling in identifying specific features and resolving modes of failure. The features include a nearly flat failure terrace mantled with sand boils, collapse craters and sediment flows, and bounded on the seaward side by a meandering continuous toe ridge. Seaward of the terrace lies a compression zone delineated by small pressure ridges. Our findings indicate a temporal progression of failure from lique-faction of shallow subsurface sand to lateral spread of intact blocks to sediment collapse and flow.

Field, Michael E.; Hall, Robert K.

1982-09-01

135

CpG motifs in bacterial DNA cause inflammation in the lower respiratory tract.  

PubMed

Since unmethylated CpG motifs are more frequent in DNA from bacteria than vertebrates, and the unmethylated CpG motif has recently been reported to have stimulatory effects on lymphocytes, we speculated that bacterial DNA may induce inflammation in the lower respiratory tract through its content of unmethylated CpG motifs. To determine the role of bacterial DNA in lower airway inflammation, we intratracheally instilled prokaryotic and eukaryotic DNA in C3H/HeBFEJ mice and performed whole lung lavage 4 h after the exposure. Heat denatured, single stranded Escherichia coli genomic DNA (0.06 ng endotoxin/microg DNA) was compared to heat denatured, single stranded calf thymus DNA (0.007 endotoxin/microg DNA). 10 microg of bacterial DNA, in comparison to 10 microg of calf thymus DNA, resulted in a fourfold increase in the concentration of cells (P = 0.0002), a fivefold increase in the concentration of neutrophils (P = 0.0002), a 50-fold increase in the concentration of TNF-alpha (P = 0.001), and a fourfold increase in the concentration of both IL-6 (P = 0.0003) and macrophage inflammatory protein-2 (P = 0.0001) in the lavage fluid. Importantly, instillation of 0.60 ng of E. coli LPS resulted in a negligible inflammatory response. To test whether the stimulatory effects of bacterial DNA are due to its unmethylated CpG dinucleotides, we methylated the bacterial DNA and also prepared 20 base pair oligonucleotides with and without CpG motifs. In comparison to instillation of untreated bacterial DNA, methylation of the bacterial DNA resulted in a significant reduction in the concentration of cells and cytokines in the lower respiratory tract. Moreover, oligonucleotides containing embedded unmethylated CpG motifs resulted in inflammation in the lower respiratory tract that was indistinguishable from that observed with untreated bacterial DNA. In contrast, oligonucleotides without the embedded CpG motifs or with embedded but methylated CpG motifs resulted in significantly less inflammation in the lower respiratory tract. The possible relevance of these data to human disease was shown by extracting and analyzing DNA in sputum from patients with cystic fibrosis (CF). Approximately 0.1 to 1% of this sputum DNA was bacterial. Intratracheal instillation of highly purified CF sputum DNA caused acute inflammation similar to that induced by bacterial DNA. These findings suggest that bacterial DNA, and unmethylated CpG motifs in particular, may play an important pathogenic role in inflammatory lung disease. PMID:9202058

Schwartz, D A; Quinn, T J; Thorne, P S; Sayeed, S; Yi, A K; Krieg, A M

1997-07-01

136

Spontaneous Pneumomediastinum, Pneumopericardium, and Pneumothorax with Respiratory Failure in a Patient with AIDS and Pneumocystis jirovecii Pneumonia  

PubMed Central

Spontaneous pneumothorax occurs in up to 35% of patients with Pneumocystis jirovecii pneumonia. However, spontaneous pneumomediastinum and pneumopericardium are uncommon complications in patients infected with human immunodeficiency virus, with no reported incidence rates, even among patients with acquired immunodeficiency syndrome (AIDS) and P. jirovecii pneumonia. We report a case of spontaneous pneumomediastinum, pneumopericardium, and pneumothorax with respiratory failure during treatment of P. jirovecii pneumonia in a patient with AIDS; the P. jirovecii infection was confirmed by performing methenamine silver staining of bronchoalveolar lavage specimens. This case suggests that spontaneous pneumomediastinum and pneumopericardium should be considered in patients with AIDS and P. jirovecii pneumonia.

Park, Yun Kyung; Jung, Hee Chan; Kim, Shin Young; Kim, Min Young; Jo, Kwanhoon; Kim, Se Young; Kang, Borami; Woo, Gihyeon; Choi, Hyun Joo

2014-01-01

137

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

138

A huge bladder calculus causing acute renal failure.  

PubMed

We present a 39-year-old man with repeated urinary tract infection and lower abdominal pain. Kidney-ureter-bladder (KUB) and IVU film showed a huge 450-g elliptical pelvic calculus that was surgically removed with excellent results. Surgical intervention by cystolithotomy or endoscopic cystolithotripsy can achieve satisfactory results. Bladder outlet obstruction should be treated simultaneously. Bladder stone is a common disease, but it is rare for such a calculus to be so large as to cause bilateral hydronephrosis. Close follow-up, however, is mandatory because the recurrence of urolithiasis is high in those patients with voiding problems and recurrent urinary infection. To the best of our knowledge, this is the largest bladder stone in a human male. PMID:20033143

Wei, Wuran; Wang, Jia

2010-08-01

139

[Causes of disturbances in iron turnover in chronic renal failure].  

PubMed

In many patients with chronic renal insufficiency a depletion of stored and cellular iron (absolute iron deficiency), a blockade of iron in body stores (functional iron deficiency) or an iron overload can be shown. The factors leading to absolute iron deficiency are: 1) loss of iron as a result of blood loss by the gastrointestinal tract, taking blood specimens for laboratory tests and related to dialytic procedure; 2) enhanced use of iron during intensive erythropoiesis stimulated by recombinant human erythropoietin; 3) dietary iron deficiency or impaired iron uptake from the gastrointestinal tract; 4) other forms of gastrointestinal tract impairment; 5) pharmaceutical substances forming inabsorbable iron complexes and/or diluting the acidity of the gastric juice; 6) certain demographic factors. Functional iron deficiency develops during treatment with recombinant human erythropoietin and in the infectious state and during the inflammatory process. The use of recombinant human erythropoietin accelerates erythropoesis and by so increases iron requirement frequently far higher than the ability of iron stores to "transfer" iron to the bone marrow--this may be a result of ineffective mobilisation of iron stores and/or ineffective transport. In the infectious process the use of iron is impaired because of augmented cytokines production which leads to increase iron uptake and storage in the reticulo-endothelial system. Iron overload is caused by excessive iron intake, e.g. parenteral iron administration or repeated blood transfusions. PMID:12089896

Prusak, Ma?gorzata; Grzegorzewska, Alicja E

2002-04-01

140

Causes of dysregulation of lipid metabolism in chronic renal failure  

PubMed Central

End-stage renal disease (ESRD) is associated with accelerated atherosclerosis and premature death from cardiovascular disease. These events are driven by oxidative stress inflammation and lipid disorders. ESRD-induced lipid abnormalities primarily stem from dysregulation of high-density lipoprotein (HDL) and triglyceride-rich lipoprotein metabolism and oxidative modification of lipoproteins. In this context, production and plasma concentration of Apo-I and Apo-II are reduced, HDL maturation is impaired, HDL composition is altered, HDL anti-oxidant and anti-inflammatory functions are depressed, clearance of triglyceride-rich lipoproteins and their atherogenic remnants is impaired, their composition is altered, and their plasma concentration is elevated in ESRD. The associated defect in HDL maturation is largely caused by acquired lecithin-cholesterol acyltransferase (LCAT) deficiency while its triglyceride enrichment is due to hepatic lipase deficiency. Hyper-triglyceridemia, abnormal composition, and impaired clearance of triglyceride-rich lipoproteins and their remnants are mediated by down-regulation of lipoprotein lipase, hepatic lipase, VLDL receptor, and LDL receptor-related protein (LRP), relative reduction of ApoC-II/ApoC-III ratio, upregulation of acyl-CoA cholesterol acyltransferase (ACAT) and elevated plasma level of cholesterol ester-poor pre-beta HDL. Impaired clearance and accumulation of oxidation- prone VLDL and chylomicron remnants and abnormal LDL composition in the face of oxidative stress and inflammation favors their uptake by macrophages and resident cells in the artery wall. The effect of heightened influx of lipids is compounded by impaired HDL-mediated reverse cholesterol transport leading to foam cell formation which is the central event in atherosclerosis plaque formation and subsequent plaque rupture, thrombosis and tissue damage. PMID:20017835

Vaziri, Nosratola D.

2010-01-01

141

77 FR 5857 - Common-Cause Failure Analysis in Event and Condition Assessment: Guidance and Research, Draft...  

Federal Register 2010, 2011, 2012, 2013

...REGULATORY COMMISSION [NRC-2011-0254] Common-Cause Failure Analysis in Event and...published for public comment Draft NUREG, ``Common- Cause Failure Analysis in Event and...published for public comment Draft NUREG, ``Common-Cause Failure Analysis in Event...

2012-02-06

142

76 FR 67764 - Common-Cause Failure Analysis in Event and Condition Assessment: Guidance and Research, Draft...  

Federal Register 2010, 2011, 2012, 2013

...REGULATORY COMMISSION [NRC-2011-0254] Common-Cause Failure Analysis in Event and...NUREG, NUREG-xxxx, Revision 0, ``Common-Cause Failure Analysis in Event and...draft NUREG offers guidance for assessing common-cause failure (CCF) potential at...

2011-11-02

143

Failure of early postnatal dexamethasone to prevent chronic lung disease in infants with respiratory distress syndrome  

Microsoft Academic Search

OBJECTIVE: To study the effect of early postnatal dexamethasone (days 1-3) on the incidence and severity of chronic lung disease in preterm infants with respiratory distress syndrome. METHODS: A multicentre, randomised, placebo controlled, blinded study was carried out in 18 neonatal intensive care units in Israel. The primary outcome measure was survival to discharge without requirement for supplemental oxygen therapy

E. S. Shinwell; M. Karplus; E. Zmora; D. Reich; A. Rothschild; S. Blazer; D. Bader; S. Yurman; T. Dolfin; J. Kuint; B. Milbauer; D. Kohelet; M. Goldberg; Y. Armon; S. Davidson; L. Sirota; M. Amitai; A. Zaretsky; M. Barak; S. Gottfried

1996-01-01

144

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

145

Mechanisms of bioprosthetic heart valve failure: Fatigue causes collagen denaturation and glycosaminoglycan loss  

E-print Network

IR spectroscopy (FTIR). The cyclic fatigue caused a progressive loss of helicity of the bioprostheticMechanisms of bioprosthetic heart valve failure: Fatigue causes collagen denaturation region. Furthermore, car- diac valve fatigue in these studies also led to loss of gly- cosaminoglycans

Zand, Robert

146

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

147

An implicit method for incorporating common-cause failures in system analysis  

Microsoft Academic Search

A general procedure incorporates common-cause (CC) failures into system analysis by an implicit method; i.e., after first solving the system probability equation without CC failures. Components of subsets are assumed to be equally vulnerable to CC of any particular multiplicity. The method allows for age-dependent hazard rates, repairable and nonrepairable components, systems with multiple CC groups, and systems where not

Jussi K. Vaurio

1998-01-01

148

Reproductive success and causes of nest failures for Mississippi Kites: A sink population in eastern Arkansas?  

Microsoft Academic Search

In the White River National Wildlife Refuge, we located and monitored 39 Mississippi Kite (Ictinia mississippiensis) nests during the 2004 and 2005 breeding seasons to examine reproductive success and causes of nesting failures. Nest failures\\u000a were documented using five video recording systems. All kite nests not monitored with a video recording system were observed\\u000a every 3 or 4 d. The

Troy J. Bader; James C. Bednarz

2009-01-01

149

Noninvasive ventilatory support does not facilitate recovery from acute respiratory failure in chronic obstructive pulmonary disease  

Microsoft Academic Search

Noninvasive ventilatory support does not facilitate recovery from acute respiratory fail- ure in chronic obstructive pulmonary disease. F. Barbé, B. Togores, M. Rubí, S. Pons, A. Maimó, A.G.N. Agustí. ©ERS Journals Ltd 1996. ABSTRACT: This investigation evaluates, in a prospective, randomized and con- trolled manner, whether noninvasive ventilatory support (NIVS) with bilevel posi- tive airway pressure (BiPAP) facilitates recovery from

F. Barbé; B. Togores; M. Rubí; S. Pons; A. Maimó; A. G. N. Agustí

1996-01-01

150

Cause and analysis of stator and rotor failures in three-phase squirrel-cage induction motors  

Microsoft Academic Search

The squirrel cage induction motor has limitations, which, if exceeded, will result in premature failure of the stator or rotor. The authors identify the various causes of stator and rotor failures. A specific methodology is proposed to facilitate an accurate analysis of these failures. Failures of the bearings and lubrication systems are excluded

Austin H. Bonnett; George C. Soukup

1992-01-01

151

Causes for failure of ACL reconstruction and influence of meniscectomies after revision.  

PubMed

The purpose of this multicenter retrospective study was to analyze the causes for failure of ACL reconstruction and the influence of meniscectomies after revision. This study was conducted over a 12-year period, from 1994 to 2005 with ten French orthopaedic centers participating. Assessment included the objective International Knee Documenting Committee (IKDC) 2000 scoring system evaluation. Two hundred and ninety-three patients were available for statistics. Untreated laxity, femoral and tibial tunnel malposition, impingement, failure of fixation were assessed, new traumatism and infection were recorded. Meniscus surgery was evaluated before, during or after primary ACL reconstruction, and then during or after revision ACL surgery. The main cause for failure of ACL reconstruction was femoral tunnel malposition in 36% of the cases. Forty-four percent of the patients with an anterior femoral tunnel as a cause for failure of the primary surgery were IKDC A after revision versus 24% if the cause of failure was not the femoral tunnel (P = 0.05). A 70% meniscectomy rate was found in revision ACL reconstruction. Comparison between patients with a total meniscectomy (n = 56) and patients with preserved menisci (n = 65) revealed a better functional result and knee stability in the non-meniscectomized group (P = 0.04). This study shows that the anterior femoral tunnel malposition is the main cause for failure in ACL reconstruction. This reason for failure should be considered as a predictive factor of good result of revision ACL reconstruction. Total meniscectomy jeopardizes functional result and knee stability at follow-up. PMID:20644911

Trojani, Christophe; Sbihi, Abderahmane; Djian, Patrick; Potel, Jean-François; Hulet, Christophe; Jouve, Frank; Bussière, Christophe; Ehkirch, François-Paul; Burdin, Gilles; Dubrana, Frédéric; Beaufils, Philippe; Franceschi, Jean-Pierre; Chassaing, Vincent; Colombet, Philippe; Neyret, Philippe

2011-02-01

152

Impact of early surfactant and inhaled nitric oxide therapies on outcomes in term/late preterm neonates with moderate hypoxic respiratory failure  

PubMed Central

Objective: We conducted a post-hoc analysis of early inhaled nitric oxide (iNO)-randomized controlled trial data to identify associations pertinent to the management of moderate hypoxic respiratory failure in term/late preterm infants. Study design: Univariate and multivariate logistic regression analyses were used to determine risk factors for the progression of respiratory failure and extracorporeal membrane oxygenation (ECMO)/death. Result: Among the 299 enrolled infants, oxygenation index (OI) <20 at enrollment (odds ratio 0.52, confidence interval (CI) 0.27 to 0.97) and surfactant use before randomization (odds ratio 0.47, CI 0.24 to 0.91) were associated with decreased ECMO/death rates. Early surfactant use for respiratory distress syndrome, perinatal aspiration syndrome and pneumonia/sepsis was associated with lower risk of ECMO/death (P<0.001). Early iNO (OI 15 to 25) decreased the progression of respiratory failure to OI >30 (P=0.002) and to composite outcome of OI >30 or ECMO/death (P=0.02). Conclusion: This post-hoc analysis suggests that early use of surfactant and iNO in moderate respiratory failure is associated with improved outcomes. PMID:23867958

Konduri, G G; Sokol, G M; Van Meurs, K P; Singer, J; Ambalavanan, N; Lee, T; Solimano, A

2013-01-01

153

Fatal renal failure caused by diethylene glycol in paracetamol elixir: the Bangladesh epidemic.  

PubMed Central

OBJECTIVE--To determine the cause of a large increase in the number of children with unexplained renal failure. DESIGN--Case-control study. SETTING--Children's hospital in Dhaka, Bangladesh. SUBJECTS--Cases were all 339 children with initially unexplained renal failure; controls were 90 children with cause of renal failure identified; all were admitted to hospital during 35 months after January 1990. MAIN OUTCOME MEASURES--Differences between the case and control patients in clinical and histological features and outcome; toxicological examination of 69 bottles of paracetamol from patients and pharmacies. RESULTS--Compared with children with an identified cause for their renal failure, children with initially unexplained renal failure were significantly (P < 0.05) more likely to have hepatomegaly (58% v 33%), oedema (37% v 20%), and hypertension (58% v 23%); to have a higher serum creatinine concentration (mean 519 mumol/l v 347 mumol/l) and lower serum bicarbonate concentration (10.1 mmol/l v 12.4 mmol/l); to have been given a drug for fever (91% v 31%); to have ingested a brand of paracetamol shown to contain diethylene glycol (20% v 0%); and to have died in hospital (70% v 33%). Diethylene glycol was identified in 19 bottles of paracetamol, from 7 of 28 brands tested. In the 12 months after a government ban on the sale of paracetamol elixir, new cases of renal failure decreased by 54%, and cases of unexplained renal failure decreased by 84%. CONCLUSION--Paracetamol elixirs with diethylene glycol as a diluent were responsible for a large outbreak of fatal renal failure in Bangladesh. PMID:7613408

Hanif, M.; Mobarak, M. R.; Ronan, A.; Rahman, D.; Donovan, J. J.; Bennish, M. L.

1995-01-01

154

HumanMetapneumo virusas a Cause of Community-Acquired Respiratory Illness  

Microsoft Academic Search

Human metapneumovirus (HMPV) is a recently identified Paramyxovirus first isolated from hospitalized children with acute respiratory tract infections (ARTI). We sought evidence of HMPV infection in patients who had visited general practitioners, had influenzalike illnesses (ILI), and had negative tests for influenza and Human respiratory syncytial virus (HRSV). As part of national virologic surveillance, sentinel general practices in England and

Joanne Stockton; Iain Stephenson; Douglas Fleming; Maria Zambon

155

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

156

Causes of Failure after Total Knee Arthroplasty in Osteoarthritis Patients 55 Years of Age or Younger  

PubMed Central

Purpose To identify the modes of failure after total knee arthroplasty (TKA) in patients >55 years of age and to compare with those >55 years of age in patients who underwent revision TKA. Materials and Methods We retrospectively reviewed 256 revision TKAs among patients who underwent TKA for knee osteoarthritis between January 1992 and December 2012. The causes of TKA failure were analyzed and compared between the groups. Results Thirty-one revision TKAs were performed in patients ?55 years of age at the time of primary TKA, whereas 225 cases were in those >55 years of age at primary TKA. In the ?55 years of age group, the most common cause of TKA failure was polyethylene wear (45%) followed by infection (26%) and loosening (17%). The interval from primary TKA to revision was 8.6 years (range, 1 to 17 years). There were relatively lower infection rate and higher loosening rate in patients ?55 years of age, but the difference was not statistically significant. Conclusions The main causes of failure after TKA in patients ?55 years of age were polyethylene wear, infection and loosening, and there was no significant difference in the modes of failure after TKA between the two groups. PMID:24639942

Lee, Song; Ko, Dong Oh; Seo, Bong Soo; Jung, Woo Shik; Chang, Byung Kwon

2014-01-01

157

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

158

Idiopathic Infantile Arterial Calcification: A Possible Cause of Refractory Cardiopulmonary Failure in Infancy  

PubMed Central

Idiopathic Infantile Arterial Calcification is a rare autosome recessive disease characterized by extensive calcification of medium and large arteries. Loss-of-function mutations in ectonucleotide pyrophosphatase/phosphodiesterase 1 gene have been described in more than 80% of the cases. Although the diagnosis is usually made at autopsy, it is possible to identify cases based on clinical presentation, radiology findings, and molecular studies. Appropriate treatment can be initiated and has been shown to successfully induce permanent remission. We report a 4-week-old neonate who initially presented with respiratory distress, heart failure, and Coxsackie B viremia suggestive of viral induced cardiomyopathy. His symptoms progressed to multiple organ failure and he eventually expired at four weeks of age. On autopsy, diffuse calcium deposition within the internal elastic lamina of medium and large arteries was identified, as well as narrowing of lumen due to myointimal proliferation. This case report will emphasize the importance of taking this rare curable disease into consideration in all cases of infants with cardiopulmonary failure. PMID:24660083

Nael, A.; Siaghani, P. J.; Chen, D.; Romansky, S. G.; Shane, L.

2014-01-01

159

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

160

Causes of Failure in Web Applications Soila Pertet and Priya Narasimhan  

E-print Network

: a single hour of downtime could cost a retailer thousands of dollars in lost sales. For example, during an estimated $25,000 per minute of downtime [1]. The true costs of downtime are much higher: lost, and lost employee productivity [2]. This report investigates the causes of failure in Web applications

161

Evaluation of basic causes of repetitive failures of nuclear and fossil feedwater pumps. Final report  

Microsoft Academic Search

This report presents an evaluation of service experience with nuclear and fossil feedwater pumps. The scope includes all US commercial light water reactors over 430 MWe in operation in June 1978 and all US fossil fired units over 600 MWe in operation in December 1977. Presented in the report are: the root causes of repetitive failures of feedwater pumps, an

1980-01-01

162

103 Senile systemic amyloidosis: a common cause of heart failure in the elderly?  

Microsoft Academic Search

Senile systemic amyloidosis (SSA) is a rare cause of heart failure due to the deposition of wildtype transthyretin. The clinical features and outcome are ill defined; our aim was to evaluate the natural history of the disease in the UK in a group of thoroughly characterised patients. The series included all cases of biopsy proven transthyretin (TTR) amyloidosis with wildtype

J H Pinney; H J Lachmann; J D Gillmore; A Wechalekar; S D J Gibbs; P Sattianayagam; S M Banypersad; J Dungu; N Wassef; C A McCarthy; P N Hawkins; C J Whelan

2011-01-01

163

Repopulation of cancer cells during therapy: an important cause of treatment failure  

Microsoft Academic Search

Radiotherapy and chemotherapy are given in multiple doses, which are spaced out to allow the recovery of normal tissues between treatments. However, surviving cancer cells also proliferate during the intervals between treatments and this process of repopulation is an important cause of treatment failure. Strategies developed to overcome repopulation have improved clinical outcomes, and now new strategies to inhibit repopulation

John J. Kim; Ian F. Tannock

2005-01-01

164

ESTABLISHING PUBLIC POLICY AS A PRIMARY CAUSE OF ENGINEERING FAILURE IN NATIONAL INFRASTRUCTURES  

E-print Network

ESTABLISHING PUBLIC POLICY AS A PRIMARY CAUSE OF ENGINEERING FAILURE IN NATIONAL INFRASTRUCTURES intervention, which led to problems in the operation of the energy market. The following paper applies accident to support his or her concerns about the problems in today's electric industry". Many of the differences

Williamson, John

165

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

166

Noninvasive ventilation for prevention of post-extubation respiratory failure in obese patients  

Microsoft Academic Search

Current recommendations for management of obese patients post-extubation are based on clinical experience and expert opinions. It was hypothesised that the application of noninvasive ventilation (NIV) during the first 48 h after extubation in severely obese patients would reduce post-extubation failure and avert the need for reintubation. Following protocol-driven weaning trials, 62 consecutive severely obese patients (body mass index o35

A. A. El Solh; A. Aquilina; L. Pineda; V. Dhanvantri; B. Grant; P. Bouquin

2006-01-01

167

An Elderly Man with Fatal Respiratory Failure after Eating a Poisonous Mushroom Podostroma cornu-damae.  

PubMed

A 73-year-old, previously healthy man presented with nausea, vomiting, diarrhea, dry mouth and febrile sensation 3 hours after eating boiled wild mushrooms. After admission, he showed progressive severe respiratory distress, pancytopenia, azotemia, hypotension, hypoxemia and consolidation of the entire left lung on chest radiography. With a preliminary diagnosis of necrotizing pneumonia, he underwent left pneumonectomy in order to remove all necrotic lung tissue. Lung histology showed extensive hemorrhagic necrosis, massive inflammatory cell infiltration, prominent proliferation of young fibroblasts and the formation of an early-stage hyaline membrane along the alveolar wall. Despite aggressive treatment, including mechanical ventilation, continuous renal replacement therapy and administration of granulocyte colony stimulating factor and broad spectrum antibiotics, he died on hospitalization day 13. Subsequently, the mushroom was identified as Podostroma cornu-damae. This is the first case of a histological evidence of lung involvement by Podostroma cornu-damae poisoning in Korea. PMID:24416059

Jang, Juah; Kim, Cheol-Hong; Yoo, Jun Jae; Kim, Mi Kang; Lee, Jae Eun; Lim, Ah Leum; Choi, Jeong-Hee; Hyun, In Gyu; Shim, Jung Weon; Shin, Ho-Seung; Han, Joungho; Seok, Soon Ja

2013-12-01

168

Respiratory dysfunction in guillain-barré syndrome  

Microsoft Academic Search

Guillain-Barré Syndrome is the leading cause of nontraumatic acute paralysis in industrialized countries. About 30% of patients\\u000a have respiratory failure requiring intensive care unit (ICU) admission and invasive mechanical ventilation. Progressive weakness\\u000a of both the inspiratory and the expiratory muscles is the mechanism leading to respiratory failure. Aspiration pneumonia and\\u000a atelectasis are common consequences of the bulbar muscle weakness and

David Orlikowski; Hélène Prigent; Tarek Sharshar; Frédéric Lofaso; Jean Claude Raphael

2004-01-01

169

Severe respiratory illness caused by a novel coronavirus, in a patient transferred to the United Kingdom from the Middle East, September 2012.  

PubMed

Coronaviruses have the potential to cause severe transmissible human disease, as demonstrated by the severe acute respiratory syndrome (SARS) outbreak of 2003. We describe here the clinical and virological features of a novel coronavirus infection causing severe respiratory illness in a patient transferred to London, United Kingdom, from the Gulf region of the Middle East. PMID:23078800

Bermingham, A; Chand, M A; Brown, C S; Aarons, E; Tong, C; Langrish, C; Hoschler, K; Brown, K; Galiano, M; Myers, R; Pebody, R G; Green, H K; Boddington, N L; Gopal, R; Price, N; Newsholme, W; Drosten, C; Fouchier, R A; Zambon, M

2012-01-01

170

A giant inguinoscrotal bladder hernia as a cause of chronic renal failure: A rare case  

PubMed Central

INTRODUCTION Giant inguinoscrotal bladder hernias are very rare and require surgical intervention. They usually do not cause any specific symptoms and thus, they are often misdiagnosed. If left untreated though, they might lead to severe medical conditions, such as renal failure. PRESENTATION OF CASE We present the case of a 71-year-old male patient suffering from a giant inguinoscrotal mass, accompanied by symptoms of the lower urinary track (LUTS) and chronic renal failure. DISCUSSION In our case, the patient presented with bladder hernia causing non specific symptoms of renal failure. In contrast to acute renal failure, a chronic renal impairment most often comes with no specific symptoms and thus, it can be present for many years before the diagnosis is made. It is evident that such serious conditions should be suspected and treated. CONCLUSION Inguinoscrotal bladder hernias may be associated with severe medical conditions, such as renal deterioration, and should be considered in the differential diagnosis of renal failure, when accompanied by any inguinal, scrotal, or low abdominal wall hernia. PMID:23416505

Karatzas, Anastasios; Christodoulidis, Gregory; Spyridakis, Michael; Stavaras, Christos; Aravantinos, Evangelos; Melekos, Michael

2013-01-01

171

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

172

[Primary peritonitis combined with streptococcal toxic shock syndrome following an upper respiratory tract infection caused by Streptococcus pyogenes].  

PubMed

A 52-year-old woman with no previous history of major health problems presented with an acute abdomen and symptoms of shock. Three days earlier she had been diagnosed as having acute laryngitis which was treated with steroids. On admission she was suffering from hypotension, renal failure, liver failure and coagulopathy. Emergency laparotomy revealed purulent fluid spread diffusely throughout the abdominal cavity. Streptococcus pyogenes was grown in culture from this fluid, enabling a diagnosis of streptococcal toxic shock syndrome (STSS) with primary peritonitis to be made. This combination is rare, and has been described only a few times. Only one other patient is known in whom this combination was preceded by respiratory symptoms. The treatment consists of abdominal lavage, intravenous administration of antibiotics and immunoglobulins, and support for renal function, liver function, respiration and coagulation. PMID:18512531

Van Den Bossche, M J A; Devriendt, D; Weyne, L; Van Ranst, M

2008-04-12

173

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

174

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.

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

2014-01-01

175

Failure of early postnatal dexamethasone to prevent chronic lung disease in infants with respiratory distress syndrome.  

PubMed Central

OBJECTIVE: To study the effect of early postnatal dexamethasone (days 1-3) on the incidence and severity of chronic lung disease in preterm infants with respiratory distress syndrome. METHODS: A multicentre, randomised, placebo controlled, blinded study was carried out in 18 neonatal intensive care units in Israel. The primary outcome measure was survival to discharge without requirement for supplemental oxygen therapy beyond 28 days of life. The secondary outcome measures were requirement for mechanical ventilation at 3 and 7 days, duration of ventilation or oxygen therapy, need for subsequent steroids for established chronic lung disease and incidence of major morbidities. RESULTS: The study consisted of 248 infants (dexamethasone n = 132; placebo n = 116). No differences were found in the outcome variables except for a reduction in requirement for mechanical ventilation at age 3 days in treated infants (dexamethasone 44%, placebo 67%; P = 0.001). Gastrointestinal haemorrhage, hypertension, and hyperglycaemia were more common in treated infants, but no life threatening complications, such as gastrointestinal perforation, were encountered. CONCLUSIONS: These data do no support the routine use of early postnatal steroids, but may justify further study in a selected, high risk group of infants. PMID:8653433

Shinwell, E. S.; Karplus, M.; Zmora, E.; Reich, D.; Rothschild, A.; Blazer, S.; Bader, D.; Yurman, S.; Dolfin, T.; Kuint, J.; Milbauer, B.; Kohelet, D.; Goldberg, M.; Armon, Y.; Davidson, S.; Sirota, L.; Amitai, M.; Zaretsky, A.; Barak, M.; Gottfried, S.

1996-01-01

176

Effects of mechanical insufflation-exsufflation in preventing respiratory failure after extubation: a randomized controlled trial  

PubMed Central

Introduction Weaning protocols that include noninvasive ventilation (NIV) decrease re-intubation rates and ICU length of stay. However, impaired airway clearance is associated with NIV failure. Mechanical insufflation-exsufflation (MI-E) has been proven to be very effective in patients receiving NIV. We aimed to assess the efficacy of MI-E as part of an extubation protocol. Method Patients with mechanical ventilation (MV) for more than 48 hours with specific inclusion criteria, who successfully tolerated a spontaneous breathing trial (SBT), were randomly allocated before extubation, either for (A) a conventional extubation protocol (control group), or (B) the MI-E extubation protocol (study group). During the postextubation period (48 hours), group A patients received standard medical treatment (SMT), including NIV in case of specific indications, whereas group B received the same postextubation approach plus three daily sessions of mechanical in-exsufflation (MI-E). Reintubation rates, ICU length of stay, and NIV failure rates were analyzed. Results Seventy-five patients (26 women) with a mean age of 61.8 ± 17.3 years were randomized to a control group (n = 40; mean SAPS II, 47.8 ± 17.7) and to a study group (n = 35; mean SAPS II, 45.0 ± 15.0). MV time before enrollment was 9.4 ± 4.8 and 10.5 ± 4.1 days for the control and the study group, respectively. In the 48 hours after extubation, 20 control patients (50%) and 14 study patients (40%) used NIV. Study group patients had a significant lower reintubation rate than did controls; six patients (17%) versus 19 patients (48%), P < 0.05; respectively, and a significantly lower time under MV; 17.8 ± 6.4 versus 11.7 ± 3.5 days; P < 0.05; respectively. Considering only the subgroup of patients that used NIV, the reintubation rates related to NIV failure were significantly lower in the study group when compared with controls; two patients (6%) versus 13 (33%); P < 0.05, respectively. Mean ICU length of stay after extubation was significantly lower in the study group when compared with controls (3.1 ± 2.5 versus 9.8 ± 6.7 days; P < 0.05). No differences were found in the total ICU length of stay. Conclusion Inclusion of MI-E may reduce reintubation rates with consequent reduction in postextubation ICU length of stay. This technique seems to be efficient in improving the efficacy of NIV in this patient population. PMID:22420538

2012-01-01

177

In-vitro renal epithelial cell infection reveals a viral kidney tropism as a potential mechanism for acute renal failure during Middle East Respiratory Syndrome (MERS) Coronavirus infection  

PubMed Central

Background The Middle East Respiratory Syndrome Coronavirus (MERS-CoV) causes symptoms similar to Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV), yet involving an additional component of acute renal failure (ARF) according to several published case reports. Impairment of the kidney is not typically seen in Coronavirus infections. The role of kidney infection in MERS is not understood. Findings A systematic review of communicated and peer-reviewed case reports revealed differences in descriptions of kidney involvement in MERS versus SARS patients. In particular, ARF in MERS patients occurred considerably earlier after a median time to onset of 11 days (SD ±2,0 days) as opposed to 20 days for SARS, according to the literature. In-situ histological staining of the respective cellular receptors for MERS- and SARS-Coronavirus showed highly similar staining patterns with a focus of a receptor-specific signal in kidney epithelial cells. Comparative infection experiments with SARS- and MERS-CoV in primary human kidney cells versus primary human bronchial epithelial cells showed cytopathogenic infection only in kidney cells, and only if infected with MERS-CoV. Kidney epithelial cells produced almost 1000-fold more infectious MERS-CoV progeny than bronchial epithelial cells, while only a small difference was seen between cell types when infected with SARS-CoV. Conclusion Epidemiological studies should analyze kidney impairment and its characteristics in MERS-CoV. Virus replication in the kidney with potential shedding in urine might constitute a way of transmission, and could explain untraceable transmission chains leading to new cases. Individual patients might benefit from early induction of renoprotective treatment. PMID:24364985

2013-01-01

178

Non-invasive proportional assist and pressure support ventilation in patients with cystic fibrosis and chronic respiratory failure  

PubMed Central

Background: Patients with advanced cystic fibrosis can benefit from non-invasive positive pressure ventilation (NPPV) for the treatment of acute decompensation as well as for the management of chronic respiratory failure. This study was undertaken to compare the physiological effects of non-invasive proportional assist ventilation (PAV) and pressure support ventilation (PSV) on ventilatory pattern, transcutaneous blood gas tensions, and diaphragmatic effort in stable patients with cystic fibrosis and chronic CO2 retention. Methods: In 12 patients two periods of spontaneous breathing were followed randomly by PSV (12 (3) cm H2O) and PAV (flow assist 4.9 (1.3) cm H2O/l.s, volume assist 18.9 (5.1) cm H2O/l) set for the patient's comfort and administered for 40 minutes with 2 cm H2O continuous positive airway pressure. Ventilatory pattern, transcutaneous blood gas tensions, and surface diaphragmatic electromyography were measured in the last 10 minutes of each application. Results: On average, both PSV and PAV improved ventilation (+30%), tidal volume (+30%), and transcutaneous CO2 (-7%) while reducing diaphragmatic activity (-30% with PSV, -20% with PAV). Mean inspiratory airway pressure was lower during PAV than during PSV (9.7 (1.9) and 12.9 (2.7) cm H2O, respectively; p<0.05). The mean coefficient of variation of tidal volume was about 20% (range 11–39%) during spontaneous breathing and did not change with either PAV or PSV. Conclusions: These results show that short term administration of nasal PAV and PSV to patients with stable cystic fibrosis with chronic respiratory insufficiency is well tolerated, improves ventilation and blood gas tensions, and unloads the diaphragm. PMID:11809990

Serra, A; Polese, G; Braggion, C; Rossi, A

2002-01-01

179

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

180

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

181

Multiple imputation methods for nonparametric inference on cumulative incidence with missing cause of failure.  

PubMed

We propose a nonparametric approach for cumulative incidence estimation when causes of failure are unknown or missing for some subjects. Under the missing at random assumption, we estimate the cumulative incidence function using multiple imputation methods. We develop asymptotic theory for the cumulative incidence estimators obtained from multiple imputation methods. We also discuss how to construct confidence intervals for the cumulative incidence function and perform a test for comparing the cumulative incidence functions in two samples with missing cause of failure. Through simulation studies, we show that the proposed methods perform well. The methods are illustrated with data from a randomized clinical trial in early stage breast cancer. Copyright © 2014 John Wiley & Sons, Ltd. PMID:25043107

Lee, Minjung; Dignam, James J; Han, Junhee

2014-11-20

182

Particulate Air Pollution and Health Effects for Cardiovascular and Respiratory Causes in Temuco, Chile: A Wood-Smoke-Polluted Urban Area  

Microsoft Academic Search

Temuco is one of the most highly wood-smoke-polluted cities in the world. Its population in 2004 was 340,000 inhabitants with 1587 annual deaths, of which 24% were due to cardiovascular and 11% to respiratory causes. For hospital admissions, cardiovascular diseases represented 6% and respiratory diseases 13%. Emergency room visits for acute respiratory infections represented 28%. The objective of the study

Pedro A. Sanhueza; Monica A. Torreblanca; Luis A. Diaz-Robles; L. Nicolas Schiappacasse; Maria P. Silva; Teresa D. Astete; Jeff Chanton; Roger Green; Junyu Zheng; Wenwei Che; Xuemei Wang; Peter Louie; Liuju Zhong; Elizabeth Vega; Douglas Lowenthal; Hugo Ruiz; Elizabeth Reyes; John Watson; Judith Chow; Mar Viana; Xavier Querol; Andres Alastuey; Mark Gibson; Mathew Heal; David Bache; Andrew Hursthouse; Iain Beverland; Susanne Craig; Colin Clark; Mike Jackson; Nicholas Nussbaum; Dongzi Zhu; Hampden Kuhns; Claudio Mazzoleni; M.-C. Chang; Hans ller; David Sodeman; Sebastian Uppapalli; Melanie Sattler; Divya Garrepalli; Chandraprakash Nawal; Daniel Burgard; Melissa Provinsal; Lien-Te Hsieh; Ya-Fen Wang; Gia-Hao Kuo; Lin-Chi Wang; Guo-Ping Chang-Chien

2009-01-01

183

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

184

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

185

The effect of PEEP on oxygenating capacity in acute respiratory failure with sepsis.  

PubMed

We report an evaluation of the effect of postive-end-expiratory-pressure (PEEP) on improving pulmonary oxygenating capacity in the adult respiratory distress syndrome (ARDS), when the latter is associated with generalized gram-negative sepsis. Fifty-seven cases treated in our RICU with PEEP ventilation (April 1972 to January 1975) were retrospectively reviewed. Oxygenating capacity improvement was evaluated in terms of the changes in PaO2/FIO2 and AaDO2 (FIO2 = 1.0). Both the short term (2-3 hours from the initiation of PEEP) and the overall effects of PEEP were evaluated. A mean PEEP of 5.6 cm H2O initially increased PaO2/FIO2 by a mean of 94 torr and decreased AaDO2 (FIO2 = 1.0) by 105 torr in the 28 nonseptic patients. In the 29 septic patients, 5.1 cm H2O PEEP initially increased PaO2/FIO2 by 32 torr and decreased AsDO2 (FIO2 = 1.0) by 38 torr. The differences between the septic and nonseptic patients were statistically significant (P less than 0.001). Likewise, the long-term effect of similar levels of PEEP was in increasing PaO2/FIO2 by 142 torr and by 75 torr in the nonseptic and septic patients, respectively. The final reduction in AaDO2 (FIO2 = 1.0) was 163 torr and 87 torr in the nonseptic and septic patients, respectively. These differences between patient groups were also statistically significant (P less than 0.02). Mortality during PEEP was 15/29 and 3/28 in the septic and nonseptic patients, respectively. Overall mortality in the septic and nonseptic groups was 18/29 and 5/28, respectively. We conclude that ARDS with sepsis constitutes a more severe pulmonary insult than ARDS without sepsis, and/or that generalized sepsis creates a more prolonged pulmonary insult that makes it less amenable to PEEP. Thus, high levels of PEEP may be needed to treat ARDS associated with sepsis. PMID:780054

Cotev, S; Perel, A; Katzenelson, R; Eimerl, D

1976-01-01

186

Causes for failure of ACL reconstruction and influence of meniscectomies after revision  

Microsoft Academic Search

The purpose of this multicenter retrospective study was to analyze the causes for failure of ACL reconstruction and the influence\\u000a of meniscectomies after revision. This study was conducted over a 12-year period, from 1994 to 2005 with ten French orthopaedic\\u000a centers participating. Assessment included the objective International Knee Documenting Committee (IKDC) 2000 scoring system\\u000a evaluation. Two hundred and ninety-three patients

Christophe Trojani; Abderahmane Sbihi; Patrick Djian; Jean-François Potel; Christophe Hulet; Frank Jouve; Christophe Bussière; François-Paul Ehkirch; Gilles Burdin; Frédéric Dubrana; Philippe Beaufils; Jean-Pierre Franceschi; Vincent Chassaing; Philippe Colombet; Philippe Neyret

2011-01-01

187

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

188

Rapid Identification of Nine Microorganisms Causing Acute Respiratory Tract Infections by Single-Tube Multiplex Reverse Transcription-PCR: Feasibility Study  

Microsoft Academic Search

Acute respiratory tract infections (ARIs) are leading causes of morbidity and, in developing countries, mortality in children. A multiplex reverse transcription-PCR (RT-PCR) assay was developed to allow in one test the detection of nine different microorganisms (enterovirus, influenza A and B viruses, respiratory syncytial virus (RSV), parainfluenzaviruses type 1 and type 3, adenovirus, Mycoplasma pneumoniae, and Chlamydia pneumoniae) that do

BRITTA GRONDAHL; WOLFRAM PUPPE; ANDREA HOPPE; INKA KUHNE; JOSEF A. I. WEIGL; HEINZ-JOSEF SCHMITT

1999-01-01

189

[Iatrogenic "metalloma" (titanoma) caused by implant failure in "metal-backed" patellar joint surface replacement].  

PubMed

Patellofemoral problems frequently provide the cause for revisions after total knee replacements (TKR). Problems with metal-backed patellae, in particular, have been reported on in the past, with a failure rate of 33%. As a result of implant failure, there is an increase of polyethylene and metallic wear, which eventually leads to a synovialitis and metallosis. We report a case of a iatrogenic induced metallosis of the knee joint resulting from failure of a metal-backed patella component with the formation of a substantial pseudotumor within the popliteal fossa. Intraoperatively, a browny-grey, knotted and hard structure was to be seen, which histologically imposed as a hyalinated scar tissue with black particular deposits. Energy dispersive X-ray microanalysis showed a high level of titanium within the intra- and extracellular deposits. In differential diagnosis these findings were postulated as "metalloma" (titanoma). In cases of periprosthetic pseudotumors, particular those with implant failure, a iatrogenic-induced metalloma should be considered. PMID:11995225

Büttner-Janz, Karin; Müller, M; Müller, K M; Friemann, J

2002-03-01

190

Antiviral activity in vitro of two preparations of the herbal medicinal product Sinupret® against viruses causing respiratory infections.  

PubMed

Sinupret(®), a herbal medicinal product made from Gentian root, Primula flower, Elder flower, Sorrel herb, and Verbena herb is frequently used in the treatment of acute and chronic rhinosinusitis and respiratory viral infections such as common cold. To date little is known about its potential antiviral activity. Therefore experiments have been performed to measure the antiviral activity of Sinupret(®) oral drops (hereinafter referred to as "oral drops") and Sinupret(®) dry extract (hereinafter referred to as "dry extract"), in vitro against a broad panel of both enveloped and non-enveloped human pathogenic RNA and DNA viruses known to cause infections of the upper respiratory tract: influenza A, Chile 1/83 (H1N1) virus (FluA), Porcine Influenza A/California/07/2009 (H1N1) virus (pFluA), parainfluenza type 3 virus (Para 3), respiratory syncytial virus, strain Long (RSV), human rhinovirus B subtype 14 (HRV 14), coxsackievirus subtype A9 (CA9), and adenovirus C subtype 5 (Adeno 5). Concentration-dependent antiviral activity (EC(50) between 13.8 and 124.8 ?g/ml) of Sinupret(®) was observed against RNA as well as DNA viruses independent of a viral envelope. Remarkable antiviral activity was shown against Adeno 5, HRV 14 and RSV in which dry extract was significantly superior to oral drops. This could be ascertained with different assays as plaque-reduction assays in plaque forming units (PFU), the analyses of a cytopathogenic effect (CPE) and with enzyme immunoassays (ELISA) to determine the amount of newly synthesised virus. Our results demonstrate that Sinupret(®) shows a broad spectrum of antiviral activity in vitro against viruses commonly known to cause respiratory infections. PMID:22112724

Glatthaar-Saalmüller, B; Rauchhaus, U; Rode, S; Haunschild, J; Saalmüller, A

2011-12-15

191

Mycoplasma agassizii causes upper respiratory tract disease in the desert tortoise.  

PubMed Central

The desert tortoise is listed by the United States government as a threatened species in part of its range. A major contributing factor in the decline of this animal has been the presence of an upper respiratory tract disease (URTD) which is characterized by a chronic disease which eventually leads to severe occlusion of the nares with viscous exudate and destruction of the respiratory epithelium. Electron microscopy of infected tissues demonstrated the presence of a mycoplasma-like organism attached to the respiratory surfaces. The mycoplasma was isolated and designated as a new species, with the proposed name Mycoplasma agassizii. The current study was designed to fulfill Koch's postulates and determine if M. agassizii was the etiologic agent of URTD. Clinically healthy animals with known antibody status were infused intranasally with pooled exudate (n = 8) from ill donor animals, with M. agassizii alone (n = 9) or in combination with Pasteurella testudinis (n = 8), with P. testudinis alone (n = 9), or with sterile broth (n = 12). The pooled exudate was culture positive for M. agassizii. Tortoises which received exudate or M. agassizii alone or in conjunction with P. testudinis were significantly more likely to develop clinical disease (P < 0.0004) than animals which received P. testudinis alone or the broth controls. Tortoises demonstrated a strong immune response to M. agassizii, and seroconversion was seen in all groups with clinical disease. M. agassizii was isolated from the upper respiratory tracts of clinically ill animals up to 6 months postinfection. On the basis of the results of these transmission studies, we conclude that M. agassizii is an etiologic agent of URTD in the desert tortoise. Images PMID:7927724

Brown, M B; Schumacher, I M; Klein, P A; Harris, K; Correll, T; Jacobson, E R

1994-01-01

192

[40 years after the last polio epidemic. Postpolio syndrome as a cause of "weaning failure"].  

PubMed

About 80,000 polio survivors are still living 40 years after the last polio epidemics in Germany. Of these 40-70% have developed the so called post-polio syndrome (PPS) decades after the infection. The main symptoms of PPS are decreasing strength in voluntary muscles, pain and fatigue which occur spontaneously but may also be induced by physical stress and general illness. We report the case of a 79-year-old male who developed hypercapnia due to ventilatory failure which necessitated reintubation several times after cholecystectomy. The medical history revealed that he had had poliomyelitis at the age of 8 years. There was only a slight residual handicap from this infection which included mild pareses of the left limbs but had remained stable for about 70 years. Electromyography revealed signs of chronic neurogenic changes in muscles of the left upper limb as well as in the pectoralis major. The diagnostic criteria of a post-polio syndrome were fulfilled and other neuromuscular diseases were excluded. The patient could be discharged from intensive care only after treatment by intermittent positive pressure ventilation via a facial mask. This case report shows that even patients who have a mild handicap after poliomyelitis can develop weaning problems. A PPS can exacerbate with inclusion of respiratory muscles in critically ill patients. PMID:12125309

Gaul, C; Winterholler, M

2002-05-01

193

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

194

[Acute ear trauma caused by failure of mobile phone/cellular phone].  

PubMed

The case of acute acoustic and burn ear trauma caused by mobile phone failure is presented. A woman aged 24 after dialling a phone number and putting a phone into the ear heard a sound of high frequency and intensity. At the same time she felt a pain and heat and there was also a smoke from the phone. With otoscopic examination a burn of external acoustic duct (I0) and sensitive hearing loss (examination made with tuning forks) were stated. The patient did not agree to stay in hospital and she was administered prednizone, trimetazidin and xantylol nicotinate. Audiometric examination, which was made on another day, showed hearing loss of 30 dB for frequency 4000Hz. After 2 days she started to hear a sound like a sea noise in her right ear. In the control examination, made 2 weeks after injury, no abnormalities in audiogram were stated but the patient steal heard ear noise. She continued to take trimetazidin and betahistin and after one month all symptoms of ear injury relieved. Patient is still under control of otolaryngologist. Unfortunately our efforts to explain the cause of such accident from phone producer were ineffective. Described case proves that mobile phone failure can be a cause of acute ear injury. PMID:18260236

Amernik, Katarzyna; Kabaci?ska, Anna; Tarnowska, Czes?awa; Paradowska-Opa?ka, Beata

2007-01-01

195

Respiratory depression due to unsuspected narcotic ingestion treated with naloxone.  

PubMed Central

Two patients are presented with respiratory depression for which no cause was apparent. Both had ingested narcotics without the parents' knowledge. Narcotic ingestion should be suspected if signs of respiratory failure with constricted pupils are present, and a diagnostic test with naloxone should be performed. PMID:686779

Curnock, D A

1978-01-01

196

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

197

HIV Reservoirs and Immune Surveillance Evasion Cause the Failure of Structured Treatment Interruptions: A Computational Study  

PubMed Central

Continuous antiretroviral therapy is currently the most effective way to treat HIV infection. Unstructured interruptions are quite common due to side effects and toxicity, among others, and cannot be prevented. Several attempts to structure these interruptions failed due to an increased morbidity compared to continuous treatment. The cause of this failure is poorly understood and often attributed to drug resistance. Here we show that structured treatment interruptions would fail regardless of the emergence of drug resistance. Our computational model of the HIV infection dynamics in lymphoid tissue inside lymph nodes, demonstrates that HIV reservoirs and evasion from immune surveillance themselves are sufficient to cause the failure of structured interruptions. We validate our model with data from a clinical trial and show that it is possible to optimize the schedule of interruptions to perform as well as the continuous treatment in the absence of drug resistance. Our methodology enables studying the problem of treatment optimization without having impact on human beings. We anticipate that it is feasible to steer new clinical trials using computational models. PMID:22558348

Mancini, Emiliano; Castiglione, Filippo; Bernaschi, Massimo; de Luca, Andrea; Sloot, Peter M. A.

2012-01-01

198

Ribosomal protein deficiency causes Tp53-independent erythropoiesis failure in zebrafish.  

PubMed

Diamond-Blackfan anemia is an inherited genetic disease caused by mutations in ribosomal protein genes. The disease is characterized by bone marrow failure, congenital anomalies, and a severe erythroid defect. The activation of the TP53 pathway has been suggested to be critical for the pathophysiology of Diamond-Blackfan anemia. While this pathway plays a role in the morphological defects that associate with ribosomal protein loss-of-function in animal models, its role in the erythroid defects has not been clearly established. To understand the specificity of erythroid defects in Diamond-Blackfan anemia, we knocked down five RP genes (two Diamond-Blackfan anemia-associated and three non-Diamond-Blackfan anemia-associated) in zebrafish and analyzed the effects on the developmental and erythroid phenotypes in the presence and absence of Tp53. The co-inhibition of Tp53 activity rescued the morphological deformities but did not alleviate the erythroid aplasia indicating that ribosomal protein deficiency causes erythroid failure in a Tp53-independent manner. Interestingly, treatment with L-Leucine or L-Arginine, amino acids that augment mRNA translation via mTOR pathway, rescued the morphological defects and resulted in a substantial recovery of erythroid cells. Our results suggest that altered translation because of impaired ribosome function could be responsible for the morphological and erythroid defects in ribosomal protein-deficient zebrafish. PMID:24417973

Yadav, Gnaneshwar V; Chakraborty, Anirban; Uechi, Tamayo; Kenmochi, Naoya

2014-04-01

199

A cardiovascular-respiratory control system model including state delay with application to congestive heart failure in humans  

Microsoft Academic Search

This paper considers a model of the human cardiovascular-respiratory control system with one and two transport delays in the state equations describing the respiratory system. The effectiveness of the control of the ventilation rate is influenced by such transport delays because blood gases must be transported a physical distance from the lungs to the sensory sites where these gases are

Jerry J. Batzel; Franz Kappel; Susanne Timischl-Teschl

2005-01-01

200

Early failure of a non-cemented femoral stem after minimal-invasive total hip arthroplasty: cause analysis and classification.  

PubMed

In this paper, we present a 77-year-old female patient with an early failure of a non-cemented femoral stem 6 months after implantation. We evaluate possible reasons for the implant failure in our case against the literature. Risk factors for stem failure include a BMI >30, varus implantation, a high femoral canal cortex ratio, and a small implant. It should be distinguished between modular and non-modular stems as well as cemented and non-cemented. Early failure would be <1 year postoperatively, late failure >1 year postoperatively. A classification of stem failure differentiating time and cause is suggested as this seems to be missing in the literature. PMID:22562648

Benthien, Jan P; Siepen, Wolf

2014-06-01

201

Viral agents causing lower respiratory tract infections in hospitalized children: evaluation of the Speed-Oligo® RSV assay for the detection of respiratory syncytial virus  

Microsoft Academic Search

Respiratory syncytial virus (RSV) is the viral agent which is more frequently involved in lower respiratory tract infections\\u000a (LRTIs) in infants under 1 year of age in developed countries. A new oligochromatographic assay, Speed-Oligo® RSV, was designed\\u000a and optimized for the specific detection and identification of RSV subtypes A and B. The test was evaluated in 289 clinical\\u000a samples from

W. Sánchez-Yebra; J. A. Ávila-Carrillo; F. Giménez-Sánchez; A. Reyes-Bertos; M. Sánchez-Forte; M. Morales-Torres; A. Rojas; J. Mendoza

202

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

203

Assessment of filter dust characteristics that cause filter failure during hot-gas filtration  

SciTech Connect

The high-temperature filtration of particulates from gases is greatly limited because of the development of dust cakes that are difficult to remove and can bridge between candle filters, causing them to break. Understanding the conditions leading to the formation of cohesive dust can prevent costly filter failures and ensure higher efficiency of solid fuel, direct-fired turbine power generation systems. The University of North Dakota Energy & Environmental Research Center is working with the New Energy and Industrial Technology Development Organization and the U.S. Department of Energy to perform research to characterize and determine the factors that cause the development of such dust cakes. Changes in the tensile strength, bridging propensity, and plasticity of filter dust cakes were measured as a function of the temperature and a filter pressure drop for a coal and a biomass filter dust. The biomass filter dust indicated that potential filtering problems can exist at temperatures as low as 400{sup o}C, while the coal filter dust showed good filtering characteristics up to 750{sup o}C. A statistically valid model that can indicate the propensity of filters to fail with system operating conditions was developed. A detailed analysis of the chemical aspect of dusts is also presented in order to explore the causes of such stickiness. 16 refs., 10 figs., 3 tabs.

John P. Hurley; Biplab Mukherjee; Michael D. Mann [University of North Dakota, Grand Forks, ND (United States). Energy & Environmental Research Center

2006-08-15

204

Stratgies for Diversity Usage to Mitigate Postulated Common Cause Failure Vulnerabilities  

SciTech Connect

This paper describes an approach to establish effective mitigating strategies that can resolve potential common-cause failure (CCF) vulnerabilities in instrumentation and control systems at nuclear power plants. A particular objective in the development of these strategies, which consist of combinations of diversity attributes and their associated criteria, is to address the unique characteristics of digital technology that can contribute to CCF concerns. The research approach employed to establish diversity strategies involves investigation of available documentation on diversity usage and experience from nuclear power and non-nuclear industries, capture of expert knowledge and lessons learned, determination of common practices, and assessment of the nature of CCFs and compensating diversity attributes. The resulting diversity strategies address considerations such as the effect of technology choices, the nature of CCF vulnerabilities, and the prospective impact of each diversity type. In particular, the impact of each attribute and criterion on the purpose, process, product, and performance aspects of diverse systems are considered.

Wood, Richard Thomas [ORNL; Waterman, Michael E. [U.S. Nuclear Regulatory Commission

2011-01-01

205

CFD research on runaway transient of pumped storage power station caused by pumping power failure  

NASA Astrophysics Data System (ADS)

To study runaway transient of pumped storage power station caused by pumping power failure, three dimensional unsteady numerical simulations were executed on geometrical model of the whole flow system. Through numerical calculation, the changeable flow configuration and variation law of some parameters such as unit rotate speed,flow rate and static pressure of measurement points were obtained and compared with experimental data. Numerical results show that runaway speed agrees well with experimental date and its error was 3.7%. The unit undergoes pump condition, brake condition, turbine condition and runaway condition with flow characteristic changing violently. In runaway condition, static pressure in passage pulses very strongly which frequency is related to runaway speed.

Zhang, L. G.; Zhou, D. Q.

2013-12-01

206

Acute respiratory failure due to hemothorax after posterior correction surgery for adolescent idiopathic scoliosis: a case report  

PubMed Central

Background Although posterior correction and fusion surgery using pedicle screws carries the risk of vascular injury, a massive postoperative hemothorax in a patient with adolescent idiopathic scoliosis (AIS) is quite rare. We here report a case of a 12-year-old girl with AIS who developed a massive postoperative hemothorax. Case presentation The patient had a double thoracic curve with Cobb angles of 63° at T2-7 and 54° at T7-12. Posterior correction and fusion surgery was performed using a segmental pedicle screw construct placed between T2 and T12. Although the patient's respiration was stable during the surgery, 20 minutes after removing the trachea tube, the patient’s pulse oximetry oxygen saturation suddenly decreased to 80%. A contrast CT scan showed a massive left hemothorax, and a drainage tube was quickly inserted into the chest. The patient was re-intubated and a positive end-expiratory pressure of 5 cmH2O applied, which successfully stopped the bleeding. The patient was extubated 4 days after surgery without incident. Based on contrast CT scans, it was suspected that the hemothorax was caused by damage to the intercostal arteries or branches during pedicle probing on the concave side of the upper thoracic curve. Extensive post-surgical blood tests, echograms, and CT and MRI radiographs did not detect coagulopathy, pulmonary or vascular malformation, or any other possible causative factors. Conclusion This case underscores the potential risk of massive hemothorax related to thoracic pedicle screw placement, and illustrates that for this serious complication, respiratory management with positive airway pressure, along with a chest drainage tube, can be an effective treatment option. PMID:23577922

2013-01-01

207

Tracheal agenesis as a rare cause of difficult intubation in a newborn with respiratory distress: a case report  

PubMed Central

Introduction Tracheal agenesis is a very rare congenital airway anomaly. It may pose a great challenge to the first attending physician both in diagnosis and in establishing the airway during the first day of life. Case presentation We report a newborn Malay baby boy with trachea agenesis (type III by Floyd's classification) who presented with severe respiratory distress immediately after birth. Clinical diagnosis in this case was not straightforward, as it started with difficulty in intubation followed by an unsuccessful emergency tracheostomy in the neonatal intensive care unit. Urgent surgical neck exploration with endoscopic examination in the general operating theatre revealed the final diagnosis. The authors present a short description of the embryopathology and diagnostic criteria of the abnormality. Conclusion We hope this case presentation will be valuable in increasing the awareness of physicians about this rare cause of tracheal obstruction or difficult intubation. PMID:19946583

2009-01-01

208

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

PubMed Central

Globally, people are struggling with obesity. Many effective, non-conventional 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

Radha Krishna, Y; Mittal, V; Grewal, P; Fiel, MI; Schiano, T

2011-01-01

209

Heart failure causes cholinergic transdifferentiation of cardiac sympathetic nerves via gp130-signaling cytokines in rodents  

PubMed Central

Although several cytokines and neurotrophic factors induce sympathetic neurons to transdifferentiate into cholinergic neurons in vitro, the physiological and pathophysiological roles of this remain unknown. During congestive heart failure (CHF), sympathetic neural tone is upregulated, but there is a paradoxical reduction in norepinephrine synthesis and reuptake in the cardiac sympathetic nervous system (SNS). Here we examined whether cholinergic transdifferentiation can occur in the cardiac SNS in rodent models of CHF and investigated the underlying molecular mechanism(s) using genetically modified mice. We used Dahl salt-sensitive rats to model CHF and found that, upon CHF induction, the cardiac SNS clearly acquired cholinergic characteristics. Of the various cholinergic differentiation factors, leukemia inhibitory factor (LIF) and cardiotrophin-1 were strongly upregulated in the ventricles of rats with CHF. Further, LIF and cardiotrophin-1 secreted from cultured failing rat cardiomyocytes induced cholinergic transdifferentiation in cultured sympathetic neurons, and this process was reversed by siRNAs targeting Lif and cardiotrophin-1. Consistent with the data in rats, heart-specific overexpression of LIF in mice caused cholinergic transdifferentiation in the cardiac SNS. Further, SNS-specific targeting of the gene encoding the gp130 subunit of the receptor for LIF and cardiotrophin-1 in mice prevented CHF-induced cholinergic transdifferentiation. Cholinergic transdifferentiation was also observed in the cardiac SNS of autopsied patients with CHF. Thus, CHF causes target-dependent cholinergic transdifferentiation of the cardiac SNS via gp130-signaling cytokines secreted from the failing myocardium. PMID:20051627

Kanazawa, Hideaki; Ieda, Masaki; Kimura, Kensuke; Arai, Takahide; Kawaguchi-Manabe, Haruko; Matsuhashi, Tomohiro; Endo, Jin; Sano, Motoaki; Kawakami, Takashi; Kimura, Tokuhiro; Monkawa, Toshiaki; Hayashi, Matsuhiko; Iwanami, Akio; Okano, Hideyuki; Okada, Yasunori; Ishibashi-Ueda, Hatsue; Ogawa, Satoshi; Fukuda, Keiichi

2010-01-01

210

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

211

Acute intermittent porphyria causes hepatic mitochondrial energetic failure in a mouse model.  

PubMed

Acute intermittent porphyria (AIP), an inherited hepatic disorder, is due to a defect of hydroxymethylbilane synthase (HMBS), an enzyme involved in heme biosynthesis. AIP is characterized by recurrent, life-threatening attacks at least partly due to the increased hepatic production of 5-aminolaevulinic acid (ALA). Both the mitochondrial enzyme, ALA synthase (ALAS) 1, involved in the first step of heme biosynthesis, which is closely linked to mitochondrial bioenergetic pathways, and the promise of an ALAS1 siRNA hepatic therapy in humans, led us to investigate hepatic energetic metabolism in Hmbs KO mice treated with phenobarbital. The mitochondrial respiratory chain (RC) and the tricarboxylic acid (TCA) cycle were explored in the Hmbs(-/-) mouse model. RC and TCA cycle were significantly affected in comparison to controls in mice treated with phenobarbital with decreased activities of RC complexes I (-52%, (**)p<0.01), II (-50%, (**)p<0.01) and III (-55%, (*)p<0.05), and decreased activity of ?-ketoglutarate dehydrogenase (-64%, (*)p<0.05), citrate synthase (-48%, (**)p<0.01) and succinate dehydrogenase (-53%, (*)p<0.05). Complex II-driven succinate respiration was also significantly affected. Most of these metabolic alterations were at least partially restored after the phenobarbital arrest and heme arginate administration. These results suggest a cataplerosis of the TCA cycle induced by phenobarbital, caused by the massive withdrawal of succinyl-CoA by ALAS induction, such that the TCA cycle is unable to supply the reduced cofactors to the RC. This profound and reversible impact of AIP on mitochondrial energetic metabolism offers new insights into the beneficial effect of heme, glucose and ALAS1 siRNA treatments by limiting the cataplerosis of TCA cycle. PMID:24727425

Homedan, Chadi; Laafi, Jihane; Schmitt, Caroline; Gueguen, Naïg; Lefebvre, Thibaud; Karim, Zoubida; Desquiret-Dumas, Valérie; Wetterwald, Céline; Deybach, Jean-Charles; Gouya, Laurent; Puy, Hervé; Reynier, Pascal; Malthièry, Yves

2014-06-01

212

Anoxic contractile failure in rat heart myocytes is caused by failure of intracellular calcium release due to alteration of the action potential.  

PubMed Central

Anoxia of the heart causes failure of contraction before any irreversible injury occurs; the mechanism by which anoxia blocks cardiac excitation-contraction coupling is unknown. Studies in whole muscle are confounded by heterogeneity; however, achieving the low oxygen tensions required to study anoxia in a single myocyte during electrophysiological recording has been a barrier in experimental design. Guided by calculations of oxygen transport, we developed a system to insulate myocytes in an open dish from oxygen by a laminar counterflowing argon column, permitting free access to the cell by microelectrodes while maintaining a PO2 less than 0.02 torr (1 torr = 133 Pa). In the absence of glucose, the amplitude of stimulated contraction of anoxic ventricular myocytes fell to zero over 2 min after a lag period attributable to the consumption of endogenous glycogen. The cytosolic calcium concentration transient, measured by indo-1 fluorescence, fell to zero simultaneously with contraction. After the twitch had failed, microinjection of caffeine around the cell still caused a large calcium release and contraction, indicating that sarcoplasmic reticular calcium stores were not depleted. Twitch failure was accompanied by shortening and then failure of the action potential; under voltage clamp, large outward currents, reversing at the resting potential, developed during contractile failure. After failure of action potential-mediated contraction, voltage-clamp depolarization, with a large command voltage to compensate for the series-resistance error due to outward currents, restored normal twitch contraction. We conclude that anoxic contractile failure in the rat myocyte is due to alteration of the action potential and the distal pathways of excitation-contraction coupling remain essentially intact. Images PMID:3413129

Stern, M D; Silverman, H S; Houser, S R; Josephson, R A; Capogrossi, M C; Nichols, C G; Lederer, W J; Lakatta, E G

1988-01-01

213

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

214

'Ryanopathy': causes and manifestations of RyR2 dysfunction in heart failure  

PubMed Central

The cardiac ryanodine receptor (RyR2), a Ca2+ release channel on the membrane of the sarcoplasmic reticulum (SR), plays a key role in determining the strength of the heartbeat by supplying Ca2+ required for contractile activation. Abnormal RyR2 function is recognized as an important part of the pathophysiology of heart failure (HF). While in the normal heart, the balance between the cytosolic and intra-SR Ca2+ regulation of RyR2 function maintains the contraction–relaxation cycle, in HF, this behaviour is compromised by excessive post-translational modifications of the RyR2. Such modification of the Ca2+ release channel impairs the ability of the RyR2 to properly deactivate leading to a spectrum of Ca2+-dependent pathologies that include cardiac systolic and diastolic dysfunction, arrhythmias, and structural remodelling. In this article, we present an overview of recent advances in our understanding of the underlying causes and pathological consequences of abnormal RyR2 function in the failing heart. We also discuss the implications of these findings for HF therapy. PMID:23408344

Belevych, Andriy E.; Radwanski, Przemyslaw B.; Carnes, Cynthia A.; Gyorke, Sandor

2013-01-01

215

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

216

The safety of beta-blocker use in chronic obstructive pulmonary disease patients with respiratory failure in the intensive care unit  

PubMed Central

Background The safety of beta-blockers as a heart rate-limiting drug (HRLD) in patients with acute respiratory failure (ARF) due to chronic obstructive lung disease (COPD) has not been properly assessed in the intensive care unit (ICU) setting. This study aims to compare the use of beta-blocker drugs relative to non-beta-blocker ones in COPD patients with ARF due to heart rate-limiting with respect to length of ICU stay and mortality. Methods We performed a retrospective (January 2011-December 2012) case-control study in a level III ICU in a teaching hospital. It was carried out in a closed ICU by the same intensivists. All COPD patients with ARF who were treated with beta-blockers (case group) and non-beta-blocker HRLDs (control group) were included. Their demographics, reason for HRLD, cause of ARF, comorbidities, ICU data including acute physiology and chronic health evaluation (APACHE II) score, type of ventilation, heart rate, and lengths of ICU and hospital stays were collected. The mortality rates in the ICU, the hospital, and over 30 days were also recorded. Results We enrolled 188 patients (46 female, n?=?74 and n?=?114 for the case and control groups, respectively). Reasons for HRLD (case and control group, respectively) were atrial fibrillation (AF, 23% and 50%), and supraventricular tachycardia (SVT, 41.9% and 54.4%). Patients’ characteristics, APACHE II score, heart rate, duration and type of ventilation, and median length of ICU-hospital stay were similar between the groups. The mortality outcomes in the ICU, hospital, and 30 days after discharge in the case and control groups were 17.6% versus 15.8% (p?>?0.75); 18.9% versus 19.3% (p?>?0.95) and 20% versus 11% (p?>?0.47), respectively. Conclusions Our results suggest that beta-blocker use for heart rate control in COPD patients with ARF is associated with similar ICU stay length and mortality compared with COPD patients treated with other HRLDs. PMID:24495706

2014-01-01

217

Foreign Body or Hypersensitivity Granuloma of the Inner Ear following Cochlear Implantation. One possible cause of a soft failure?  

PubMed Central

Hypothesis A tissue response in the form of foreign body or a hypersensitivity reaction to cochlear implantation is common and may be one possible cause of a soft failure of cochlear implantation. Background Following a successful cochlear implantation, delayed failure may occur. The causes of a “soft” failure, that is one in which device malfunction cannot be proven, are unknown. Methods The histopathology of the temporal bones of a patient who in life had suffered a soft failure following cochlear implantation was described. In addition, the temporal bones of 8 other subjects who in life had undergone cochlear implantation were studied for evidence of a foreign body or hypersensitivity reaction. Results In the case report, a necrotizing granulomatous giant cell reaction surrounded the cochlear implant electrode track through the mastoid, middle ear, and into the cochlea in both ears. There was osteolysis of the cribrose area, otic capsule and bone between the facial nerve and cochlea, and destruction of the organ of Corti and spiral ganglion. In the additional 8 cases studied, a similar, although less pronounced, foreign body or hypersensitivity reaction was seen in 6 (75%) of the cases. Conclusions A foreign body or hypersensitivity reaction in the form of giant cells and lymphocytic cell infiltration is common following cochlear implantation and may be one possible cause of soft failure. PMID:18997635

Nadol, Joseph B.; Eddington, Donald K.; Burgess, Barbara J.

2014-01-01

218

Why do organizations not learn from incidents? Bottlenecks, causes and conditions for a failure to effectively learn.  

PubMed

If organizations would be able to learn more effectively from incidents that occurred in the past, future incidents and consequential injury or damage can be prevented. To improve learning from incidents, this study aimed to identify limiting factors, i.e. the causes of the failure to effectively learn. In seven organizations focus groups were held to discuss factors that according to employees contributed to the failure to learn. By use of a model of the learning from incidents process, the steps, where difficulties for learning arose, became visible, and the causes for these difficulties could be studied. Difficulties were identified in multiple steps of the learning process, but most difficulties became visible when planning actions, which is the phase that bridges the gap from incident investigation to actions for improvement. The main causes for learning difficulties, which were identified by the participants in this study, were tightly related to the learning process, but some indirect causes - or conditions - such as lack of ownership and limitations in expertise were also mentioned. The results illustrate that there are two types of causes for the failure to effectively learn: direct causes and indirect causes, here called conditions. By actively and systematically studying learning, more conditions might be identified and indicators for a successful learning process may be determined. Studying the learning process does, however, require a shift from learning from incidents to learning to learn. PMID:25118127

Drupsteen, Linda; Hasle, Peter

2014-11-01

219

Cosmic radiation as a cause for power device failure and possible countermeasures  

Microsoft Academic Search

DC stress tests on high power semiconductor devices at nominal device ratings yielded unexpected device failures. Without prior indication the devices were destroyed spontaneously anywhere in the bulk. The failure rate depends exponentially on the applied voltage. By transferring the test setup into a salt mine 130 m below ground we were able to prove that cosmic radiation is the

H. Kabza; H.-J. Schulze; Y. Gerstenmaier; P. Voss; J. W. W. Schmid; F. Pfirsch; K. Platzoder

1994-01-01

220

Low-Dose Dopamine in Treating Acute Renal Failure Caused by Preeclampsia  

Microsoft Academic Search

Acute renal failure is a serious complication of preeclampsia that usually requires the termination of pregnancy. We present a case of acute renal failure due to severe preeclampsia successfully treated with the infusion of a low dose of dopamine. This 25-year-old Japanese primigravida was admitted at 31 weeks of gestation for the treatment of preeclampsia. Urine output was decreased to

Kaei Nasu; Jun Yoshimatsu; Takanobu Anai; Isao Miyakawa

1996-01-01

221

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

222

Agenda benders: modelling the disruptions caused by technology failures in the workplace  

Microsoft Academic Search

There is a need to understand the impact of technology fail- ures on work. In the studies reported here, subjects' plans at the start of each day were compared with their eventual accomplishments, and failures to carry out plans were in- vestigated. A number of sources of disruption were identi- fied; they included technology failures, which had a par- ticular

Margery Eldridge; William M. Newman

1996-01-01

223

An Evaluation into the Cause of Corrosive Failure in Autophoretic Coated Material  

Microsoft Academic Search

This paper documents a study of performance failures in Autophoretic® (A-coat or AP) coatings. As AP is a proprietary process and coating material, limited research has been published regarding the field performance of this coating technique. The specific failure under analysis in this study was corrosion. The study was performed at the request of a manufacturer that was experiencing pre-mature

Sean M Derrick; Matthew A Johnson; Gary P Nola; MeadeDavid; JoyceMargaret

2012-01-01

224

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

225

Incidence and Causes of Physical Failure of Artificial Habitat Structures in Streams of Western Oregon and Washington  

Microsoft Academic Search

In recent years an increasing share of fishery management resources has been com- mitted to alteration of fish habitat with artificial stream structures. We evaluated rates and causes of physical impairment or failure for 161 fish habitat structures in 15 streams in southwest Oregon and southwest Washington, following a flood of a magnitude that recurs every 2-10 years. The incidence

CHRISTOPHER A. FRISSELL; RICHARD K. NAWA

1992-01-01

226

A Tragic Disaster Caused by the Failure of Tailings Dams Leads to the Formation of the Stava 1985 Foundation  

Microsoft Academic Search

This paper summarizes the dynamics and causes of the Stava disaster, and highlights some risky design procedures that led to the 19 July 1985 tailings dam failure. It then presents the “Stava 1985 Foundation”, which was formed to focus attention on such risks and to strengthen the culture of respect for human lives and safety.

Onofrio Sammarco

2004-01-01

227

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

228

The dilemma, causes and approaches to avoid recurrent hospital readmissions for patients with chronic heart failure  

Microsoft Academic Search

Heart failure is a progressive illness that carries significant morbidity and mortality. This highly prevalent illness leads\\u000a to frequent, costly hospitalizations with approximately 50% of patients being readmitted within 6 months of initial hospitalization.\\u000a While rehospitalization has been extensively studied in the past, little progress has been made in terms of reducing readmission\\u000a rates of heart failure patients in the last

Melody Zaya; Anita Phan; Ernst R. Schwarz

229

Acute disseminated encephalomyelitis (ADEM) following a H3N3 parainfluenza virus infection in a pregnant asthmatic woman with respiratory failure.  

PubMed

This case report relates to a 31-year-old pregnant woman, asthmatic, admitted to the intensive care unit with respiratory failure, secondary to a viral community-acquired pneumonia. A type 3 (H3N3) parainfluenza virus RNA was isolated in her throat swab. The patient developed neurological symptoms (behavioural changes, irritability, agitation and impaired consciousness) while being weaned off sedation and ventilatory support. Cerebrospinal fluid was clear with an opening pressure of 26?cm?H2O. Brain MRI showed features compatible with acute disseminated encephalomyelitis. Immune screen and EEG were normal. She was treated with intravenous methylprednisolone followed by oral prednisolone. The patient made an almost full neurological recovery within 4?weeks after starting on steroids. The patient delivered a healthy baby at 38?weeks gestation. This case highlights the importance to keep in mind rare conditions that need early recognition and prompt treatment. Brain MRI is the key to early diagnosis and treatment. PMID:25281245

Zeb, Qaiser; Alegria, Ana

2014-01-01

230

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

231

Autosomal dominant transmission of congenital hypothyroidism, neonatal respiratory distress, and ataxia caused by a mutation of NKX2-1  

Microsoft Academic Search

ObjectiveTo study the NKX2-1 gene in two half-siblings with elevated thyroid-stimulating hormone (TSH) on state screen, prolonged neonatal respiratory distress despite term gestations, and persistent ataxia, dysarthria, and developmental delay.

Daniel A. Doyle; Iris Gonzalez; Becky Thomas; Mena Scavina

2004-01-01

232

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

233

Review article Proinflammatory cytokines and viral respiratory  

E-print Network

influenza virus (SIV), porcine respiratory coronavirus (PRCV) and porcine repro- ductive and respiratory these viruses cause symptoms and pathology, how- ever, remain unresolved. Classical studies of pathogenesis have influenza virus (SIV) / porcine respiratory coronavirus (PRCV) / porcine reproductive and respiratory

Boyer, Edmond

234

Performance Evaluation of Standby Safety Systems Due to Independent and Common Cause Failures  

E-print Network

issue. Another failure mode of the standby safety critical systems is that they function spuriously when Power Plants I. INTRODUCTION Redundant channels are often employed in standby safety critical systems [1] for safety critical applications. The standby safety critical systems will be engaged to shutdown the plant

Lewis, Greg

235

Failure of cerebral autoregulation as a cause of brain dysfunction in the elderly  

Microsoft Academic Search

Cerebral blood flow in relation to change in arterial pressure was measured in 11 elderly patients with postural hypotension. Seven patients with symptoms showed bilateral or unilateral failure of cerebral autoregulation, while the four asymptomatic patients did not. Variations in cerebral autoregulation would explain why some elderly people with minor falls of systemic arterial pressure develop clinical signs of cerebral

L Wollner; S T McCarthy; N D Soper; D J Macy

1979-01-01

236

Acute renal failure caused by complete bladder eversion through a vesicovaginal fistula.  

PubMed

We report a rare case of bladder eversion through a vesicovaginal fistula. The bladder prolapse was almost complete, resulting in ureteral kinking, bilateral hydronephrosis and acute renal failure. After reduction of the bladder eversion, bilateral ureteral stent placement, fistula repair using the Latzko technique and colpocleisis, the patient had rapid resolution of her renal compromise. PMID:14752599

Dunn, James S; Bent, Alfred E; Tutrone, Ronald F; Ellerkmann, R Mark

2004-01-01

237

Diagnostic and Prognostic Utility of Brain Natriuretic Peptide in Subjects Admitted to the ICU With Hypoxic Respiratory Failure Due to Noncardiogenic and Cardiogenic Pulmonary Edema  

PubMed Central

Background Brain natriuretic peptide (BNP) is useful in diagnosing congestive heart failure (CHF) in patients presenting in the emergency department with acute dyspnea. We prospectively tested the utility of BNP for discriminating ARDS vs cardiogenic pulmonary edema (CPE). Methods We enrolled ICU patients with acute hypoxemic respiratory failure and bilateral pulmonary infiltrates who were undergoing right-heart catheterization (RHC) to aid in diagnosis. Patients with acute coronary syndrome, end-stage renal disease, recent coronary artery bypass graft surgery, or preexisting left ventricular ejection fraction ? 30% were excluded. BNP was measured at RHC. Two intensivists independently reviewed the records to determine the final diagnosis. Results Eighty patients were enrolled. Median BNP was 325 pg/mL (interquartile range [IQR], 82 to 767 pg/mL) in acute lung injury/ARDS patients, vs 1,260 pg/mL (IQR, 541 to 2,020 pg/mL) in CPE patients (p = 0.0001). The correlation between BNP and pulmonary capillary wedge pressure was modest (r = 0.27, p = 0.02). BNP offered good discriminatory performance for the final diagnosis (C-statistic, 0.80). At a cut point ? 200 pg/mL, BNP provided specificity of 91% for ARDS. At a cut point ? 1,200 pg/mL, BNP had a specificity of 92% for CPE. Higher levels of BNP were associated with a decreased odds for ARDS (odds ratio, 0.4 per log increase; p = 0.007) after adjustment for age, history of CHF, and right atrial pressure. BNP was associated with in-hospital mortality (p = 0.03) irrespective of the final diagnosis and independent of APACHE (acute physiology and chronic health evaluation) II score. Conclusion In ICU patients with hypoxemic respiratory failure, BNP appears useful in excluding CPE and identifying patients with a high probability of ARDS, and was associated with mortality in patients with both ARDS and CPE. Larger studies are necessary to validate these findings. PMID:17426196

Karmpaliotis, Dimitri; Kirtane, Ajay J.; Ruisi, Christopher P.; Polonsky, Tamar; Malhotra, Atul; Talmor, Daniel; Kosmidou, Ioanna; Jarolim, Petr; de Lemos, James A.; Sabatine, Marc S.; Gibson, C. Michael; Morrow, David

2008-01-01

238

[Neuromuscular disease: Respiratory clinical assessment and follow-up].  

PubMed

Patients with neuromuscular disease are an important group at risk of frequently suffering acute or chronic respiratory failure, which is their main cause of death. They require follow-up by a pediatric respiratory medicine specialist from birth or diagnosis in order to confirm the diagnosis and treat any respiratory complications within a multidisciplinary context. The ventilatory support and the cough assistance have improved the quality of life and long-term survival for many of these patients. In this paper, the authors review the pathophysiology, respiratory function evaluation, sleep disorders, and the most frequent respiratory complications in neuromuscular diseases. The various treatments used, from a respiratory medicine point of view, will be analyzed in a next paper. PMID:24709048

Martínez Carrasco, C; Villa Asensi, J R; Luna Paredes, M C; Osona Rodríguez de Torres, F B; Peña Zarza, J A; Larramona Carrera, H; Costa Colomer, J

2014-10-01

239

[Haemophagocytic lymphohistiocytosis syndrome: a possible cause of multi-organ failure in severe head trauma?].  

PubMed

We report the case of a 26-year-old patient who was victim of severe head trauma following a trafic road accident. Two days after trauma, she had fever, pancytopenia and multi-organ failure. The haemophagocytic lymphohistiocytosis syndrome was suspected. This diagnosis was confirmed by biologic findings (elevated serum levels of ferritin and triglycerid) and histological findings (examination of bone marrow smears showing histiocytes phagocytosing blood cells). The evolution was unfavorable despite of corticotherapy and symptomatic measures. PMID:21978480

Chaari, A; Jedidi, I; Chelly, H; Bahloul, M; Bouaziz, M

2011-11-01

240

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

241

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

242

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

243

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

244

Analysis of causes that led to toddler Steven Young's respiratory arrest, intracranial and retinal bleeding, bronchopneumonia, peritonitis, and death  

Microsoft Academic Search

Steven, a 25-month-old white male, suffered from respiratory arrest and was resuscitated and taken to St. Joseph's Hospital in Phoenix, Arizona. He was placed on mechanical ventilation and treated with epinephrine, IV fluids, antibiotics, ulcer prophylaxis, and sodium bicarbonate. No im- provement in Steven's neurological condition was observed and he was pronounced dead 20 hours following admission. An autopsy was

Mohammed Ali Al-Bayati

245

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

246

White-Etching Matter in Bearing Steel. Part II: Distinguishing Cause and Effect in Bearing Steel Failure  

NASA Astrophysics Data System (ADS)

The premature failure of large bearings of the type used in wind turbines, possibly through a mechanism called "white-structure flaking", has triggered many studies of microstructural damage associated with "white-etching areas" created during rolling contact fatigue, although whether they are symptoms or causes of failure is less clear. Therefore, some special experiments have been conducted to prove that white-etching areas are the consequence, and not the cause, of damage. By artificially introducing a fine dispersion of microcracks in the steel through heat treatment and then subjecting the sample to rolling contact fatigue, manifestations of hard white-etching matter have been created to a much greater extent than samples similarly tested without initial cracks. A wide variety of characterization tools has been used to corroborate that the white areas thus created have the same properties as reported observations on real bearings. Evidence suggests that the formation mechanism of the white-etching regions involves the rubbing and beating of the free surfaces of cracks, debonded inclusions, and voids under repeated rolling contact. It follows that the focus in avoiding early failure should be in enhancing the toughness of the bearing steel in order to avoid the initial microscopic feature event.

Solano-Alvarez, W.; Bhadeshia, H. K. D. H.

2014-10-01

247

Impaired S-nitrosylation of the ryanodine receptor caused by xanthine oxidase activity contributes to calcium leak in heart failure.  

PubMed

S-Nitrosylation is a ubiquitous post-translational modification that regulates diverse biologic processes. In skeletal muscle, hypernitrosylation of the ryanodine receptor (RyR) causes sarcoplasmic reticulum (SR) calcium leak, but whether abnormalities of cardiac RyR nitrosylation contribute to dysfunction of cardiac excitation-contraction coupling remains controversial. In this study, we tested the hypothesis that cardiac RyR2 is hyponitrosylated in heart failure, because of nitroso-redox imbalance. We evaluated excitation-contraction coupling and nitroso-redox balance in spontaneously hypertensive heart failure rats with dilated cardiomyopathy and age-matched Wistar-Kyoto rats. Spontaneously hypertensive heart failure myocytes were characterized by depressed contractility, increased diastolic Ca(2+) leak, hyponitrosylation of RyR2, and enhanced xanthine oxidase derived superoxide. Global S-nitrosylation was decreased in failing hearts compared with nonfailing. Xanthine oxidase inhibition restored global and RyR2 nitrosylation and reversed the diastolic SR Ca(2+) leak, improving Ca(2+) handling and contractility. Together these findings demonstrate that nitroso-redox imbalance causes RyR2 oxidation, hyponitrosylation, and SR Ca(2+) leak, a hallmark of cardiac dysfunction. The reversal of this phenotype by inhibition of xanthine oxidase has important pathophysiologic and therapeutic implications. PMID:20643651

Gonzalez, Daniel R; Treuer, Adriana V; Castellanos, Jorge; Dulce, Raul A; Hare, Joshua M

2010-09-10

248

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.

2014-01-01

249

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

250

Microbiologically influenced corrosion causes failure of type 304 water well screens  

SciTech Connect

Austenitic stainless steel (SS) type 304 (UNS S30400) wire and rod screens installed in fresh water wells (500 m depth) failed after {approximately} 2 years of service. The failed screens from different wells showed severe localized corrosion attack and were covered by black and reddish-brown deposits. These findings indicated the contribution of bacteria in the screen failure. The bacteria might have developed from the external contamination of fluids during well drilling and/or other sources. Water treatment to minimize the bacterial activity, such as chlorination, was not applied during well-drilling, development, and operation.

Elshawesh, F.; Elmendelsi, T.; Elhoud, A.; Abuan, E.; Elagdel, E. [Petroleum Research Center, Tripoli (Libyan Arab Jamahiriya)

1997-06-01

251

A review of poisonous plants that cause reproductive failure and malformations in the ruminants of Brazil.  

PubMed

The objective of this review is to provide a report on toxic plants causing reproductive problems in ruminants in Brazil. Aspidosperma pyrifolium causes abortion or stillbirth in goats, as well as most likely in sheep and cattle, in the semiarid regions of Northeastern Brazil. Intoxications by Ateleia glazioveana, Tetrapterys acutifolia and T. multiglandulosa result in abortion and neonatal mortality in cattle and sheep, and the same signs have been experimentally observed in goats. These three plants can also cause cardiac fibrosis and a nervous disease with spongiosis of the central nervous system. Other plants known to cause abortion include Enterolobium contortisiliquum, E. gummiferum, Stryphnodendron coriaceum, S. obovatum and S. fissuratum. These plants can also cause digestive signs and photosensitization. Abortions have been reported in animals intoxicated by nitrates and nitrites as well. Infertility, abortions and the birth of weak offspring have been reported in animals intoxicated by plants containing swainsonine, including Ipomoea spp., Turbina cordata and Sida carpinifolia. Trifolium subterraneum causes estrogenism in cattle. Mimosa tenuiflora and, most likely, M. ophthalmocentra cause malformations and embryonic mortality in goats, sheep and cattle in the semiarid regions of Northeastern Brazil. PMID:22147504

Riet-Correa, Franklin; Medeiros, Rosane M T; Schild, Ana Lucia

2012-04-01

252

Type IIIb Endoleak Is an Important Cause of Failure Following Endovascular Aneurysm Repair.  

PubMed

Purpose : To present confirmed cases of type IIIb endoleak in second and third-generation stent-grafts used for endovascular aneurysm repair (EVAR). Case Reports : Four patients developed type IIIb endoleak caused by fabric tears between 4 and 13 years following their initial EVAR. Three patients presented with rupture and one with aneurysm expansion of unknown cause. In each case, the type IIIb endoleak was confirmed at open surgery after imaging proved non-diagnostic. Only one patient survived. Had the cause for the expansion or ruptures been found prior to open reintervention, relining of the stent-graft may have been possible. Conclusion : Type IIIb endoleak remains difficult to diagnose. Avoidance of the high mortality associated with open secondary intervention requires a high degree of suspicion and it should be considered in any post-EVAR aneurysm expansion without an obvious cause. PMID:25290802

Jones, Steven M; Vallabhaneni, S Rao; McWilliams, Richard G; Naik, Jagjeeth; Nicholas, Tom; Fisher, Robert K

2014-10-01

253

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

254

Rapid identification of nine microorganisms causing acute respiratory tract infections by single-tube multiplex reverse transcription-PCR: feasibility study.  

PubMed

Acute respiratory tract infections (ARIs) are leading causes of morbidity and, in developing countries, mortality in children. A multiplex reverse transcription-PCR (RT-PCR) assay was developed to allow in one test the detection of nine different microorganisms (enterovirus, influenza A and B viruses, respiratory syncytial virus [RSV], parainfluenzaviruses type 1 and type 3, adenovirus, Mycoplasma pneumoniae, and Chlamydia pneumoniae) that do not usually colonize the respiratory tracts of humans but, if present, must be assumed to be the cause of respiratory disease. Clinical samples from 1,118 children admitted to the Department of Pediatrics because of an ARI between November 1995 and April 1998 were used for a first clinical evaluation. Detection of one of the microorganisms included in the assay was achieved for 395 of 1,118 (35%) clinical samples, of which 37.5% were RSV, 20% were influenza A virus, 12.9% were adenovirus, 10.6% were enterovirus, 8.1% were M. pneumoniae, 4.3% were parainfluenzavirus type 3, 3.5% were parainfluenzavirus type 1, 2.8% were influenza B virus, and 0.2% were C. pneumoniae. Seasonal variations in the rates of detection of the different organisms were observed, as was expected from the literature. The levels of concordance with the data obtained by commercially available enzyme immunoassays were 95% for RSV and 98% for influenza A. The results show that the multiplex RT-PCR-enzyme-linked immunosorbent assay is a useful and rapid diagnostic tool for the management of children with ARI. Studies of the overall benefit of this method with regard to the use of antibiotics, the use of diagnostic procedures including additional microbiological tests, and hospitalization rate and duration are warranted. PMID:9854054

Gröndahl, B; Puppe, W; Hoppe, A; Kühne, I; Weigl, J A; Schmitt, H J

1999-01-01

255

Diffuse idiopathic skeletal hyperostosis as a cause of acute respiratory distress in early postoperative period of total knee arthroplasty  

Microsoft Academic Search

Diffuse idiopathic skeletal hyperostosis (DISH) is a common disorder among the elderly. The diagnosis is made on radiological\\u000a findings and most of the cases are asymptomatic. In the cases with spinal involvement, bridging ossification of the anterior\\u000a longitudinal ligament is a common finding. We report a case of DISH, who developed respiratory distress after bilateral total\\u000a knee arthroplasty operation. The

Alper Gokce; Tahsin Beyzadeoglu; Lale Hanci; Fahri Erdogan

2007-01-01

256

Heart failure caused by renal arteriovenous fistula with giant renal artery aneurysms.  

PubMed

We encountered an extremely rare case of a renal arteriovenous fistula (AVF) with 2 giant renal artery aneurysms (RAAs) in a 75-year-old woman who presented with congestive heart failure and pulmonary hypertension. A chest x-ray revealed cardiomegaly with a cardiothoracic ratio (CTR) of 65%. Computed tomography showed 2 giant left RAAs (diameter, 45 × 40 mm(2) and 75 × 60 mm(2)) associated with an AVF, dilated inferior vena cava, and dilated pulmonary arteries. A radical nephrectomy was performed through a transverse laparotomy after the left renal vein, and arteries were dissected from the inferior vena cava and aorta, respectively. The patient's postoperative course was uneventful, and her condition improved. Her cardiomegaly was ameliorated, as manifested by a decrease in CTR to 57% and the absence of volume overload. PMID:25027614

Okamoto, Yuki; Sugimoto, Tsutomu; Yamamoto, Kazuo; Yoshii, Shinpei

2014-01-01

257

Bland-White-Garland syndrome - a rare and serious cause of failure to thrive  

PubMed Central

Patient: Male, 0 Final Diagnosis: Bland-White-Garland syndrome Symptoms: Cardiomegaly, feeding problems Medication: — Clinical Procedure: Reimplantation of the left coronary artery to the aorta Specialty: Pediatrics and Neonatology Objective: Rare disease Background: Bland-White-Garland syndrome (BWGS) is a very rare disease characterized by anomalous origin of the left coronary artery from the pulmonary trunk (ALCAPA). WBGS affects 1 in every 300 000 live births. Children typically present with dyspnea, pallor, and failure to thrive. Without surgical repair, most of these children die during the first months of life. Case Report: This case report describes 3-month-old boy admitted to the hospital because of feeding problems. The boy was born at term, with birth weight 3200 g, and was 10 points in Apgar score. He was breast-fed from birth. From the seventh week of age, his mother observed his increasing difficulties with feeding. Physical examination revealed pale skin, diminished heart sounds, tachycardia, cardiomegaly, and hepatomegaly. Results of urine and blood tests and ultrasonography of the central nervous system and abdomen were normal. The chest radiography showed cardiomegaly and electrocardiogram revealed anterolateral myocardial infarction. On echocardiography, an anomalous left coronary artery arising from the pulmonary artery was found. The life-saving treatment of choice was immediate surgical reimplantation of the left coronary artery to the aorta. Conclusions: Children with congenital heart disease are often prone to malnutrition, but in rare cases failure to thrive and breast-feeding problems can be the first symptoms of life-threatening diseases like myocardial infarction secondary to Bland-White-Garland syndrome (BWGS). PMID:24086793

Szmigielska, Agnieszka; Roszkowska-Blaim, Maria; Golabek-Dylewska, Malgorzata; Tomik, Agnieszka; Brzewski, Michal; Werner, Bozena

2013-01-01

258

Inference for the dependent competing risks model with masked causes of failure  

E-print Network

Benjamin Reiser Received: 12 January 2005 / Accepted: 30 November 2005 Ã? Springer Science+Business Media, Inc. 2006 Abstract The competing risks model is useful in settings in which individuals/units may die/fail for different reasons. The cause specific hazard rates are taken to be piecewise constant functions

Craiu, V. Radu

259

Polyflavonoid tannins — a main cause of soft-rot failure in CCA-treated timber  

Microsoft Academic Search

Polyflavonoid tannins are proven to be fast-reacting with CCA solutions and hence, to be strong competitors of the structural wood constituents for fixation of CCA preservatives. The consequence of this effect is that even relatively small amounts of tannin cause severe undertreatment of the structural wood constituents which in turn badly affects the long term durability of CCA treated timber.

A. Pizzi; A. Jansen

1986-01-01

260

Failure-cause analysis: condenser and associated systems. Volume 1. Final report  

Microsoft Academic Search

Steam surface condensers and their associated systems are a frequent cause of generating losses resulting from outages, load reductions, and poor performance. This study, presented in two volumes, was initiated to determine the effects of condenser and associated system problems on power plant availability and performance. Data were received from 415 power plant units, and visits were made to selected

R. J. Bell; A. M. Impagliazzo; Y. G. Mussalli

1982-01-01

261

Failure-cause analysis: condenser and associated systems. Volume 2. Final report  

Microsoft Academic Search

Steam surface condensers and their associated systems are a frequent cause of generating losses resulting from outages, load reductions, and poor performance. This study, presented in two volumes, was initiated to determine the effects of condenser and associated system problems on power plant availability and performance. Data were received from 415 power plant units, and visits were made to selected

R. J. Bell; A. M. Impagliazzo; Y. G. Mussalli

1982-01-01

262

Atelectasis Causes Vascular Leak and Lethal Right Ventricular Failure in Uninjured Rat Lungs  

Microsoft Academic Search

During mechanical ventilation, lung recruitment attenuates injury challenged (10), and from a clinical perspective, remains un- caused by high VT, improves oxygenation, and may optimize pulmo- resolved. However, low Vt is a potentially important factor nary vascular resistance (PVR). We hypothesized that ventilation in the development of atelectasis (11, 12), and this may need without recruitment would induce injury in

Michelle Duggan; Conan L. McCaul; Patrick J. McNamara; Doreen Engelberts; Cameron Ackerley; Brian P. Kavanagh

263

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

264

Kisspeptin receptor haplo-insufficiency causes premature ovarian failure despite preserved gonadotropin secretion.  

PubMed

Premature ovarian failure (POF) affects 1% of women in reproductive age, but its etiology remains uncertain. Whereas kisspeptins, the products of Kiss1 that act via Kiss1r (aka, Gpr54), are known to operate at the hypothalamus to control GnRH/gonadotropin secretion, additional actions at other reproductive organs, including the ovary, have been proposed. Yet, their physiological relevance is still unclear. We present here a series of studies in Kiss1r haplo-insufficient and null mice suggesting a direct role of kisspeptin signaling in the ovary, the defect of which precipitates a state of primary POF. Kiss1r hypomorph mice displayed a premature decline in ovulatory rate, followed by progressive loss of antral follicles, oocyte loss, and a reduction in all categories of preantral follicles. These alterations were accompanied by reduced fertility. Because of this precocious ovarian ageing, mice more than 48 weeks of age showed atrophic ovaries, lacking growing follicles and corpora lutea. This phenomenon was associated with a drop in ovarian Kiss1r mRNA expression, but took place in the absence of a decrease in circulating gonadotropins. In fact, FSH levels increased in aged hypomorph animals, reflecting loss of follicular function. In turn, Kiss1r-null mice, which do not spontaneously ovulate and have arrested follicular development, failed to show normal ovulatory responses to standard gonadotropin priming and required GnRH prestimulation during 1 week in order to display gonadotropin-induced ovulation. Yet, the magnitude of such ovulatory responses was approximately half of that seen in control immature wild-type animals. Altogether, our data are the first to demonstrate that Kiss1r haplo-insufficiency induces a state of POF, which is not attributable to defective gonadotropin secretion. We also show that the failure of follicular development and ovulation linked to the absence of Kiss1r cannot be fully rescued by (even extended) gonadotropin replacement. These findings suggest a direct ovarian role of kisspeptin signaling, the perturbation of which may contribute to the pathogenesis of POF. PMID:24885574

Gaytan, Francisco; Garcia-Galiano, David; Dorfman, Mauricio D; Manfredi-Lozano, Maria; Castellano, Juan M; Dissen, Gregory A; Ojeda, Sergio R; Tena-Sempere, Manuel

2014-08-01

265

Severe hydrotreating of diesel can cause fuel-injector pump failure  

SciTech Connect

The US and Europe are increasingly tightening diesel-fuel quality specifications, particularly with respect to sulfur content. This trend is directing the oil industry toward progressively more severe types of hydrocatalytic manufacturing. Although usually beneficial in emissions terms, the overall consequences of such processing routes are not necessarily universally beneficial. In fact, there is strong evidence that automotive diesel fuel manufactured by severe hydrotreating may increase the risk of premature mechanical failure of certain classes of automotive fuel-injection pumps. Recent events in Sweden -- where strict, environmentally driven fuel specifications have been introduced -- have confirmed the existence of this risk. In response to these events, the Royal Dutch/Shell Group of companies has attempted to quantify and solve the problem of reduced diesel fuel lubricity in that market. These circumstances in Sweden, however, have potential implications for other markets. In the US, for instance, comparable pressures are driving manufacturers toward highly processed fuels that may lead to similar problems. The paper discusses lubricity, diesel fuel quality, quality advances, lubricity implications, field trials, test-bench results, lubricity improvement, and the global picture.

Booth, M. (Shell International Petroleum Co., London (United Kingdom)); Wolveridge, P.E. (Shell Research Ltd., Chester (United Kingdom))

1993-08-16

266

Regression of long standing anorexia nervosa following acute renal failure caused by gentamicin intoxication.  

PubMed

A female patient aged 22 with fully developed symptoms of anorexia nervosa presented the following metabolic disturbances: persistent hyperuricemia, hyponatruria, (sometimes with sodium lack in urine) as well as frequent hyponatremia and hyper-uricosuria. The patient's low arterial blood pressure (70/40 mm Hg on average) was not improved by pharmacological treatment, and only high oral doses of table salt (20-70 g/24 h) did prove effective in the therapy. The subject passed seven renal calculi composed of sodium urate and uric acid. Numerous urinalyses did not reveal any changes, and bacterial cultures of the urine were also negative. After 14 years of anorexia nervosa, the patient was treated for pneumonia with gentamicin at doses of 2 x 80 mg/24 h. Following third dose of the antibiotic, the patient developed acute renal failure and was treated by haemodialysis for six weeks. The renal function came gradually to the norm. Simultaneously, all the anorexia nervosa symptoms subsided along with sodium metabolism disturbances, while purine metabolism disorders got considerably alleviated. The patient started to have her menstrual cycles again, gained 12 kg in body weight, and one year afterwards bore a son. A further 10-year follow-up period was free of any pathological changes except for a slight hyperuricemia. To the best of our knowledge, the similar case has not been reported in the medical literature and electronic data bases. PMID:16225114

Chodorowski, Zygmunt; Rutkowski, Boles?aw; Sein Anand, Jacek; Rutkowski, Przemys?aw

2005-01-01

267

Dihydrolipoamide dehydrogenase deficiency: a still overlooked cause of recurrent acute liver failure and Reye-like syndrome.  

PubMed

The causes of Reye-like syndrome are not completely understood. Dihydrolipoamide dehydrogenase (DLD or E3) deficiency is a rare metabolic disorder causing neurological or liver impairment. Specific changes in the levels of urinary and plasma metabolites are the hallmark of the classical form of the disease. Here, we report a consanguineous family of Algerian origin with DLD deficiency presenting without suggestive clinical laboratory and anatomopathological findings. Two children died at birth from hepatic failure and three currently adult siblings had recurrent episodes of hepatic cytolysis associated with liver failure or Reye-like syndrome from infancy. Biochemical investigation (lactate, pyruvate, aminoacids in plasma, organic acids in urine) was normal. Histologic examination of liver and muscle showed mild lipid inclusions that were only visible by electron microscopy. The diagnosis of DLD deficiency was possible only after genome-wide linkage analysis, confirmed by a homozygous mutation (p.G229C) in the DLD gene, previously reported in patients with the same geographic origin. DLD and pyruvate dehydrogenase activities were respectively reduced to 25% and 70% in skin fibroblasts of patients and were unresponsive to riboflavin supplementation. In conclusion, this observation clearly supports the view that DLD deficiency should be considered in patients with Reye-like syndrome or liver failure even in the absence of suggestive biochemical findings, with the p.G229C mutation screening as a valuable test in the Arab patients because of its high frequency. It also highlights the usefulness of genome-wide linkage analysis for decisive diagnosis advance in inherited metabolic disorders. PMID:23478190

Brassier, Anaïs; Ottolenghi, Chris; Boutron, Audrey; Bertrand, Anne-Marie; Valmary-Degano, Séverine; Cervoni, Jean-Paul; Chrétien, Dominique; Arnoux, Jean-Baptiste; Hubert, Laurence; Rabier, Daniel; Lacaille, Florence; de Keyzer, Yves; Di Martino, Vincent; de Lonlay, Pascale

2013-05-01

268

What is the Role of Respiratory Viruses in Community Acquired Pneumonia; What is the Best Therapy for Influenza and Other Viral Causes of CAP?  

PubMed Central

Synopsis Respiratory viruses including influenza have long been appreciated as a cause of community acquired pneumonia (CAP), particularly among children, people with serious medical co-morbidities and military recruits. They are increasingly recognized as a cause of CAP among adults, particularly older adults. Polymerase chain reaction-based testing has allowed detection of newer agents (e.g. human metapneumovirus, coronavirus HKU1 and NL63) as well as improved the ability to detect “old” viral infections such as influenza virus and rhinovirus. When PCR is used, viruses have been detected in 45–75% of children and 15–54% of adults with CAP. Co-infection with viruses and bacteria is common and it remains challenging to determine which patients have only viral infection as the cause of CAP. Treatment for influenza with neuraminidase inhibitors should be started promptly for patients with CAP when influenza is suspected or documented, regardless of evidence of bacterial co-infection. Better ways to diagnose viral CAP and to integrate detection into management are urgently needed, as well as better treatment options for non-influenza respiratory viral infections. PMID:23398872

Pavia, Andrew T

2012-01-01

269

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

PubMed Central

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, were instilled into the trachea. Arterial O2 saturation was monitored using pulse oximetry. Twelve hours after exposure, animals were euthanized and bronchoalveolar lavage fluid (BALF) and plasma 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 were 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. PMID:23727623

Rancourt, Raymond C.; Veress, Livia A.; Ahmad, Aftab; Hendry-Hofer, Tara B.; Rioux, Jacqueline S.; Garlick, Rhonda B.; White, Carl W.

2013-01-01

270

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

271

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, Jose

2011-01-01

272

Cut homeobox 1 causes chromosomal instability by promoting bipolar division after cytokinesis failure  

PubMed Central

Cell populations able to generate a large repertoire of genetic variants have increased potential to generate tumor cells that survive through the multiple selection steps involved in tumor progression. A mechanism for the generation of aneuploid cancer cells involves passage through a tetraploid stage. Supernumerary centrosomes, however, can lead to multipolar mitosis and cell death. Using tissue culture and transgenic mouse models of breast cancer, we report that Cut homeobox 1 (CUX1) causes chromosomal instability by activating a transcriptional program that prevents multipolar divisions and enables the survival of tetraploid cells that evolve to become genetically unstable and tumorigenic. Transcriptional targets of CUX1 involved in DNA replication and bipolar mitosis defined a gene expression signature that, across 12 breast cancer gene expression datasets, was associated with poor clinical outcome. The signature not only was higher in breast tumor subtypes of worse prognosis, like the basal-like and HER2+ subtypes, but also identified poor outcome among estrogen receptor-positive/node-negative tumors, a subgroup considered to be at lower risk. The CUX1 signature therefore represents a unique criterion to stratify patients and provides insight into the molecular determinants of poor clinical outcome. PMID:21245318

Sansregret, Laurent; Vadnais, Charles; Livingstone, Julie; Kwiatkowski, Nicholas; Awan, Arif; Cadieux, Chantal; Leduy, Lam; Hallett, Michael T.; Nepveu, Alain

2011-01-01

273

Respiratory Syncytial Virus Infections  

MedlinePLUS

Respiratory syncytial virus (RSV) causes mild, cold-like symptoms in adults and older healthy children. It can cause serious problems in ... tests can tell if your child has the virus. There is no specific treatment. You should give ...

274

Mechanical failure characterization of optical components caused by laser induced damage initiated at contaminants  

SciTech Connect

The goal of this research is to quantify by numerical techniques the effects of surface and subsurface absorbing defects on damage initiation and growth in high power laser optical components. The defects include laser absorbing spots (e.g., surface particulate contamination) and surface damage regions (e.g., micro-cracks and voids) which are present due to environmental exposure and fabrication processes. This report focuses on three sources of contamination that can cause damage to optical components: (1) Front surface particle contamination, (2) Back surface particle contamination, and (3) Subsurface particle contamination. The DYNA2D (non-linear structural mechanics) code was used to model the growth of damage in the glass substrate. The damage in the nominally transparent glass substrate as a result of front surface particle contamination was found to be dependent on the magnitude of the resultant pressure pulse applied to the particle and the initial area of contact between the particle and glass substrate. The pressures generated from a back surface particle being blown off the surface provided sufficient loading to severely damage (crack) the glass substrate. A subsurface Ceria dioxide particle showed a strong surface interaction that influenced the formation and direction of the damage (cracking) that ultimately resulted in the blow-out of the damaged material leaving a relatively clean crater in the glass. Crater shape and size was determined. Since fused silica is the most transparent, and therefore laser damage resistant, of the optical materials, it is used for the most at-risk optical elements. The present studies are for a fused silica substrate. Some oxides such as Ceria are transparent in the infrared and visible, but absorbing in the UV part of the spectrum. Because ICF lasers like NIF use frequency tripling, effects of such oxides must be included.

Faux, D. R., LLNL

1997-12-01

275

Respiratory pathogens: assessing resistance patterns in Europe and the potential role of grepafloxacin as treatment of patients with infections caused by these organisms.  

PubMed

Although most respiratory tract infections (RTI) are caused by viruses, various bacteria, particularly Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis, are common causes of community-acquired pneumonia, acute exacerbations of chronic bronchitis, otitis media and sinusitis. Empirical antibiotic therapy of patients with RTI must take account of the increasing prevalence of resistance among the predominant pathogens. Europe-wide susceptibility surveillance studies have revealed that resistance to penicillin and macrolides is highly prevalent among isolates of S. pneumoniae from France and Spain. Uniquely, in Italy, macrolide resistance is highly prevalent while the prevalence of penicillin resistance is low. Resistance to other antibiotic classes, including chloramphenicol, doxycycline and, in particular, co-trimoxazole, is associated with penicillin resistance in pneumococci, but resistance to the fluoroquinolones is rare. beta-Lactamase production is the principal mechanism of resistance in isolates of H. influenzae and M. catarrhalis, with fluoroquinolone resistance being detected rarely in these pathogens. In 1998 a surveillance study involving 15 European countries determined the susceptibilities of many respiratory pathogens to a range of antimicrobials, including grepafloxacin. The MIC(90) of grepafloxacin for 1251 isolates of S. pneumoniae was 0.25 mg/L, the MICs for only five strains being >2 mg/L, and 99.4% of all of the isolates tested were inhibited by concentrations respiratory tract pathogens are low in European countries. The enhanced potency and activity of grepafloxacin against isolates of S. pneumoniae, including those exhibiting resistance to unrelated classes of antibiotics, together with its activity against other respiratory tract pathogens, suggest that this drug has considerable potential as empirical therapy of patients with a wide range of RTI. PMID:10719006

Felmingham, D

2000-03-01

276

Metronidazole resistance of Trichomonas vaginalis as a cause of treatment failure in trichomoniasis--A case report.  

PubMed Central

Six isolates of a strain (MRP-MT) of Trichomonas vaginalis obtained from a woman before and after unsuccessful treatment with metronidazole had an appreciably lower susceptibility to metronidazole both in vitro in the aerobic tube assay and in vivo in the mouse assay than did control strains from patients cured with standard doses of the drug. Our results support recent evidence that metronidazole-resistant strains of T vaginalis do cause treatment failure. Resistance of these strains could be detected in vitro under only aerobic but not anaerobic conditions. The prevalence of metronidazole-resistant strains of T vaginalis should be kept under surveillance in order to estimate their clinical importance. The patient harbouring the resistant strain MRP-MT was finally cured with increased doses of ornidazole. PMID:6983379

Kulda, J; Vojtechovska, M; Tachezy, J; Demes, P; Kunzova, E

1982-01-01

277

How Is Respiratory Failure Treated?  

MedlinePLUS

... mattress on a motorized platform. The mattress gently rocks back and forth. When your head rocks down, the organs in your abdomen and your ... slide up, helping you exhale. When your head rocks up, the organs in your abdomen and your ...

278

[Serotype distribution and antibiotic susceptibilities of Streptococcus pneumoniae causing acute exacerbations and pneumonia in children with chronic respiratory diseases].  

PubMed

This study aimed to investigate serotype distribution and antimicrobial resistance of Streptococcus pneumoniae isolates obtained from children with chronic respiratory diseases admitted to hospital with a diagnosis of acute exacerbations between 2008-2010 at Marmara University Hospital, Istanbul, Turkey. Sixty one S.pneumoniae strains isolated from the respiratory samples of patients were studied for erythromycin, clindamycin, tetracyline, trimethoprim-sulphametoxazole (TMP-SMX), vancomycin, levofloxacin susceptibilities by disk diffusion method; MIC values of penicillin and ceftriaxone were determined by E-test (AB Biodisk, Sweden). Results were evaluated according to the CLSI standards. The erythromycin-clindamycin double disc method was applied for the detection of macrolide resistance phenotypes. The presence of macrolide resistance genes, ermB, mef(A)/(E), ermTR were determined by PCR using specific primers for each gene. The serotypes were determined by multiplex PCR using specific primers for 40 different serotypes. According to CLSI criteria, penicillin resistance in S.pneumoniae isolates were found to be 8.2% (5/61) and intermediate resistance rate was 54% (33/61) for oral penicillin. Penicillin resistance were found to be only 1.6% (1/61) for parenteral penicillin. Resistance rates of erythromycin, clindamycin, tetracyline, TMP-SMX were detected as 55.8%, 46%, 47.5% and 67.2%; respectively. No resistance was detected to vancomycin and levofloxacin. Constitutive macrolide-lincosamide-streptogramin B (cMLSB) phenotype and M phenotype were observed in 82.4% (n= 28) and 17.6% (n= 6) of the macrolide resistant isolates, respectively. Inducible macrolide-lincosamide-streptogramin B (iMLSB) phenotype was not detected. The macrolid resistance genotypes, ermB, mef(A)/(E), were positive 50% and 14.7%; respectively. Both ermB and mef(A)/(E) genes were detected 35.3% of the macrolid resistant isolates. None of the isolates were positive for ermTR gene. The most common S.pneumoniae serotypes were determined as serotype 19F, 23F and 6, furthermore penicillin (34%, 15.7% and 18.4%, respectively) and macrolide (38.2%, 20.6% and 14.7%, respectively) resistance rates of those serotypes were found relatively high. Serotype covarage of 7-, 10-, 13-valent conjugated pneumococcal vaccines and 23-valent pneumococcal vaccine were 65%, 67%, 69%, and 78.6%, respectively. In our country, use of the vaccines with these coverage rates has been observed to be effective in children exposed to intensive use of antibiotics with chronic lung disease. PMID:24237437

Alt?nkanat Gelmez, Gül?en; Soysal, Ahmet; Kuzdan, Canan; Karada?, Bülent; Hasdemir, Ufuk; Bak?r, Mustafa; Söyletir, Güner

2013-10-01

279

Lack of effect of nitrates on exercise tolerance in patients with mild to moderate heart failure caused by coronary disease already treated with captopril  

Microsoft Academic Search

OBJECTIVE--To test the hypothesis that the addition of nitrates improves exercise tolerance in patients with heart failure caused by coronary artery disease already treated with an angiotensin converting enzyme inhibitor and diuretics. DESIGN--Randomised, double blind, placebo controlled, 16 week treatment periods. SETTING--Outpatient clinic at a university hospital. PATIENTS--54 patients with previous myocardial infarction, symptoms of mild to moderate heart failure,

S Wieshammer; M Hetzel; J Hetzel; M Kochs; V Hombach

1993-01-01

280

Novel SNP array analysis and exome sequencing detect a homozygous exon 7 deletion of MEGF10 causing early onset myopathy, areflexia, respiratory distress and dysphagia (EMARDD)  

PubMed Central

Early-onset myopathy, areflexia, respiratory distress and dysphagia (EMARDD) is a myopathic disorder associated with mutations in MEGF10. By novel analysis of SNP array hybridization and exome sequence coverage, we diagnosed a 10-year old girl with EMARDD following identification of a novel homozygous deletion of exon 7 in MEGF10. In contrast to previously reported EMARDD patients, her weakness was more prominent proximally than distally, and involved her legs more than her arms. MRI of her pelvis and thighs showed muscle atrophy and fatty replacement. Ultrasound of several muscle groups revealed dense homogenous increases in echogenicity. Cloning and sequencing of the deletion breakpoint identified features suggesting the mutation arose by fork stalling and template switching. These findings constitute the first genomic deletion causing EMARDD, expand the clinical phenotype, and provide new insight into the pattern and histology of its muscular pathology. PMID:23453856

Pierson, Tyler Mark; Markello, Thomas; Accardi, John; Wolfe, Lynne; Adams, David; Sincan, Murat; Tarazi, Noor M.; Fajardo, Karin Fuentes; Cherukuri, Praveen F.; Bajraktari, Ilda; Meilleur, Katy G.; Donkervoort, Sandra; Jain, Mina; Hu, Ying; Lehky, Tanya J.; Cruz, Pedro; Mullikin, James C.; Bonnemann, Carsten; Gahl, William A.; Boerkoel, Cornelius F.; Tifft, Cynthia J.

2013-01-01

281

Respiratory distress in neonates  

Microsoft Academic Search

Respiratory distress due to either medical or surgical causes occurs commonly in neonates. It is the most common cause of\\u000a admission to a neonatal surgical intensive care facility in a tertiary care hospital. The distress can be caused by a variety\\u000a of clinical conditions; common conditions treated in medical intensive care units are transient tachypnea of the new born,\\u000a respiratory

Arun Kumar; V. Bhatnagar

2005-01-01

282

Heart Failure  

MedlinePLUS

Heart failure is a condition in which the heart can't pump enough blood to meet the body's needs. Heart failure does not mean that your heart has stopped ... Tiredness and shortness of breath Common causes of heart failure are coronary artery disease, high blood pressure and ...

283

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

284

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

285

The Reduced Cochlear Output and the Failure to Adapt the Central Auditory Response Causes Tinnitus in Noise Exposed Rats  

PubMed Central

Tinnitus is proposed to be caused by decreased central input from the cochlea, followed by increased spontaneous and evoked subcortical activity that is interpreted as compensation for increased responsiveness of central auditory circuits. We compared equally noise exposed rats separated into groups with and without tinnitus for differences in brain responsiveness relative to the degree of deafferentation in the periphery. We analyzed (1) the number of CtBP2/RIBEYE-positive particles in ribbon synapses of the inner hair cell (IHC) as a measure for deafferentation; (2) the fine structure of the amplitudes of auditory brainstem responses (ABR) reflecting differences in sound responses following decreased auditory nerve activity and (3) the expression of the activity-regulated gene Arc in the auditory cortex (AC) to identify long-lasting central activity following sensory deprivation. Following moderate trauma, 30% of animals exhibited tinnitus, similar to the tinnitus prevalence among hearing impaired humans. Although both tinnitus and no-tinnitus animals exhibited a reduced ABR wave I amplitude (generated by primary auditory nerve fibers), IHCs ribbon loss and high-frequency hearing impairment was more severe in tinnitus animals, associated with significantly reduced amplitudes of the more centrally generated wave IV and V and less intense staining of Arc mRNA and protein in the AC. The observed severe IHCs ribbon loss, the minimal restoration of ABR wave size, and reduced cortical Arc expression suggest that tinnitus is linked to a failure to adapt central circuits to reduced cochlear input. PMID:23516401

Matsumoto, Masahiro; Lee, Sze Chim; Zuccotti, Annalisa; Zimmermann, Ulrike; Jaumann, Mirko; Rohbock, Karin; Xiong, Hao; Knipper, Marlies

2013-01-01

286

[Respiratory complications in compressive goiters].  

PubMed

Authors' experience in respiratory complications of compressive goiter is reviewed. Three cases with typical symptoms, relative therapy and outcome are reported. Appearance of respiratory distress should urge to avoid delay in elective surgery performing. In case of acute respiratory failure, immediate emergency tracheostomy is mandatory, subsequently followed by elective intervention. In case of malignancy, if radical surgery is not possible, tracheostomy is the short and medium-term palliative surgical treatment of choice. PMID:1751337

De Toma, G; Sgarzini, G; Gabriele, R; Campli, M; Adami, E A; De Cesare, E

1991-01-01

287

Outbreak of acute respiratory disease caused by human adenovirus type 7 in a military training camp in Shaanxi, China.  

PubMed

Outbreaks of ARD associated with HAdV have been reported in military populations in many countries. Here, we report an ARD outbreak caused by HAdV-7 in a military training camp in Shaanxi Province, China, from February to March of 2012. Epidemic data and samples from the patients were collected, and viral nucleotides from samples and viral isolations were detected and sequenced. IgG and IgA antibodies against HAdV, and the neutralization antibodies against the viral strain isolated in this outbreak, were detected. Epidemiological study showed that all personnel affected were males with an average age of 19.1 years. Two peaks appeared on the epicurve and there was an 8-day interval between peaks. Laboratory results of viral nucleotide detection carried out with clinical specimens were positive for HAdV (83.33%, 15/18). Further study through serum antibody assay, virus isolation and phylogenetic analysis showed that HAdV-7 was the etiological agent responsible for the outbreak. IgA antibody began to appear on the 4th day after the onset and showed 100% positivity on the 8th day. The virus strain in the present outbreak was highly similar to the virus isolated in Hanzhong Shaanxi in 2009. We conclude that HAdV-7 was the pathogen corresponding to the outbreak, and this is the first report of an ARD outbreak caused by HAdV-7 in military persons in China. Vaccine development, as well as enhanced epidemiological and virological surveillance of HAdV infections in China should be emphasized. PMID:23734976

Yu, Pengbo; Ma, Chaofeng; Nawaz, Muhammad; Han, Lei; Zhang, Jianfang; Du, Quanli; Zhang, Lixia; Feng, Qunling; Wang, Jingjun; Xu, Jiru

2013-08-01

288

Respiratory Syncytial Virus (RSV)  

MedlinePLUS

... been added to your dashboard . RSV Respiratory syncytial virus (RSV) is a common virus that infects the lungs and breathing passages. Almost ... antiviral is medicine that kills infections caused by viruses. How can you help protect your baby from ...

289

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, Grazyna; Krasowska, Ewelina; Chmielewska-Badora, Jolanta; Zwolinski, Jacek; Sobczak, Pawel

2013-01-01

290

ABSTRACT.--A removal experiment was conducted to measure how much and by what mechanisms brood parasitic Brown-headed Cowbirds (Molothrus ater) cause nest failures in a  

E-print Network

parasitic Brown-headed Cowbirds (Molothrus ater) cause nest failures in a commonly used host, the Song y por qué me- canismos Molothrus ater ocasiona fracasos de nidificación en Melospiza melodia, una especie hospedera común. Cuando el número de M. ater hembras se redujo experimentalmente, los fracasos de

Zanette, Liana

291

Establishing Public Policy as a Primary Cause of Engineering Failure: Did Market Deregulation Lead to the North American `Blackout', August 14th 2003?  

E-print Network

to the North American `Blackout', August 14th 2003? Christopher W. Johnson, Glasgow Accident Analysis Group. The following paper applies accident investigation techniques to represent and reason about the complex in the engineering failures that led to the blackout. Keywords: Accident analysis; root cause analysis; market

Williamson, John

292

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

293

v-Src causes delocalization of Mklp1, Aurora B, and INCENP from the spindle midzone during cytokinesis failure  

SciTech Connect

Src-family tyrosine kinases are aberrantly activated in cancers, and this activation is associated with malignant tumor progression. v-Src, encoded by the v-src transforming gene of the Rous sarcoma virus, is a mutant variant of the cellular proto-oncogene c-Src. Although investigations with temperature sensitive mutants of v-Src have shown that v-Src induces many oncogenic processes, the effects on cell division are unknown. Here, we show that v-Src inhibits cellular proliferation of HCT116, HeLa S3 and NIH3T3 cells. Flow cytometry analysis indicated that inducible expression of v-Src results in an accumulation of 4N cells. Time-lapse analysis revealed that binucleation is induced through the inhibition of cytokinesis, a final step of cell division. The localization of Mklp1, which is essential for cytokinesis, to the spindle midzone is inhibited in v-Src-expressing cells. Intriguingly, Aurora B, which regulates Mklp1 localization at the midzone, is delocalized from the spindle midzone and the midbody but not from the metaphase chromosomes upon v-Src expression. Mklp2, which is responsible for the relocation of Aurora B from the metaphase chromosomes to the spindle midzone, is also lost from the spindle midzone. These results suggest that v-Src inhibits cytokinesis through the delocalization of Mklp1 and Aurora B from the spindle midzone, resulting in binucleation. -- Highlights: • v-Src inhibits cell proliferation of HCT116, HeLa S3 and NIH3T3 cells. • v-Src induces binucleation together with cytokinesis failure. • v-Src causes delocalization of Mklp1, Aurora B and INCENP from the spindle midzone.

Soeda, Shuhei [Department of Molecular Cell Biology, Graduate School of Pharmaceutical Sciences, Chiba University, Inohana 1-8-1, Chuo-ku, Chiba 260-8675 (Japan); Nakayama, Yuji, E-mail: nakayama@mb.kyoto-phu.ac.jp [Department of Molecular Cell Biology, Graduate School of Pharmaceutical Sciences, Chiba University, Inohana 1-8-1, Chuo-ku, Chiba 260-8675 (Japan); Department of Biochemistry and Molecular Biology, Kyoto Pharmaceutical University, 5 Nakauchi-cho, Misasagi, Yamashina-ku, Kyoto 607-8414 (Japan); Honda, Takuya; Aoki, Azumi; Tamura, Naoki; Abe, Kohei; Fukumoto, Yasunori [Department of Molecular Cell Biology, Graduate School of Pharmaceutical Sciences, Chiba University, Inohana 1-8-1, Chuo-ku, Chiba 260-8675 (Japan); Yamaguchi, Naoto, E-mail: nyama@faculty.chiba-u.jp [Department of Molecular Cell Biology, Graduate School of Pharmaceutical Sciences, Chiba University, Inohana 1-8-1, Chuo-ku, Chiba 260-8675 (Japan)

2013-06-10

294

Experimental heart failure causes depression-like behavior together with differential regulation of inflammatory and structural genes in the brain  

PubMed Central

Background: Depression and anxiety are common and independent outcome predictors in patients with chronic heart failure (CHF). However, it is unclear whether CHF causes depression. Thus, we investigated whether mice develop anxiety- and depression-like behavior after induction of ischemic CHF by myocardial infarction (MI). Methods and Results: In order to assess depression-like behavior, anhedonia was investigated by repeatedly testing sucrose preference for 8 weeks after coronary artery ligation or sham operation. Mice with large MI and increased left ventricular dimensions on echocardiography (termed CHF mice) showed reduced preference for sucrose, indicating depression-like behavior. 6 weeks after MI, mice were tested for exploratory activity, anxiety-like behavior and cognitive function using the elevated plus maze (EPM), light-dark box (LDB), open field (OF), and object recognition (OR) tests. In the EPM and OF, CHF mice exhibited diminished exploratory behavior and motivation despite similar movement capability. In the OR, CHF mice had reduced preference for novelty and impaired short-term memory. On histology, CHF mice had unaltered overall cerebral morphology. However, analysis of gene expression by RNA-sequencing in prefrontal cortical, hippocampal, and left ventricular tissue revealed changes in genes related to inflammation and cofactors of neuronal signal transduction in CHF mice, with Nr4a1 being dysregulated both in prefrontal cortex and myocardium after MI. Conclusions: After induction of ischemic CHF, mice exhibited anhedonic behavior, decreased exploratory activity and interest in novelty, and cognitive impairment. Thus, ischemic CHF leads to distinct behavioral changes in mice analogous to symptoms observed in humans with CHF and comorbid depression. PMID:25400562

Frey, Anna; Popp, Sandy; Post, Antonia; Langer, Simon; Lehmann, Marc; Hofmann, Ulrich; Sirén, Anna-Leena; Hommers, Leif; Schmitt, Angelika; Strekalova, Tatyana; Ertl, Georg; Lesch, Klaus-Peter; Frantz, Stefan

2014-01-01

295

Chronic kidney disease: an independent risk factor of all-cause mortality for elderly Chinese patients with chronic heart failure  

PubMed Central

Objective To evaluate the prognostic value of chronic kidney disease (CKD) in elderly Chinese patients with chronic heart failure (CHF). Methods The study consisted of 327 elderly patients with CHF. All-cause mortality was chosen as an endpoint over the median follow-up period of 345 days. Cox regression analysis was used to identify the risk factors of mortality. Results The median age of the entire cohort was 85 years (60–100 years). The mortality for 168 elderly patients with CHF and CKD (51.4% of entire cohort) was 39.9% (67 deaths), which was higher than the mortality for CHF patients without CKD [25.2% (40/159 deaths)] and the mortality for entire cohort with CHF [32.7% (107/327 deaths)]. The Cox regression analysis showed that old age [hazard ratio (HR): 1.033; 95% confidence interval (95% CI): 1.004–1.064], CKD (HR: 1.705; 95% CI: 1.132–2.567), CHF New York Heart Association (NYHA) class IV (HR: 1.913; 95% CI: 1.284–2.851), acute myocardial infarction (AMI) (HR: 1.696; 95% CI: 1.036–2.777), elevated resting heart rate (HR: 1.021; 95% CI: 1.009–1.033), and decreased plasma albumin (HR: 0.883; 95% CI: 0.843–0.925) were independent risk factors of mortality for elderly patients with CHF. Conclusions CKD was an independent risk factor of mortality for elderly Chinese patients with CHF. PMID:23341840

Fu, Shi-Hui; Zhu, Bing; Zhang, Yu-Xiao; Yi, Shuang-Yan; Liu, Yuan; Xiao, Tie-Hui; Wang, Liang; Bai, Yong-Yi; Lu, Cai-Yi; Ye, Ping; Luo, Lei-Ming

2012-01-01

296

Invasive Fungal Sinusitis Caused by Scytalidium dimidiatum in a Lung Transplant Recipient  

PubMed Central

We describe a case of invasive fungal sinusitis caused by Scytalidium dimidiatum in a lung transplant recipient. Treatment was complicated by renal failure with amphotericin B therapies. Following 6 months of voriconazole treatment, the patient remained radiographically and clinically stable for a short time before dying of respiratory failure precipitated by graft rejection. PMID:14662991

Dunn, James J.; Wolfe, Michael J.; Trachtenberg, Joel; Kriesel, John D.; Orlandi, Richard R.; Carroll, Karen C.

2003-01-01

297

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

298

Respiratory system  

NASA Technical Reports Server (NTRS)

The general anatomy and function of the human respiratory system is summarized. Breathing movements, control of breathing, lung volumes and capacities, mechanical relations, and factors relevant to respiratory support and equipment design are discussed.

Bartlett, R. G., Jr.

1973-01-01

299

H4N8 subtype avian influenza virus isolated from shorebirds contains a unique PB1 gene and causes severe respiratory disease in mice  

PubMed Central

H4N8 subtype avian influenza viruses were isolated from shorebirds in eastern Hokkaido. All the isolates shared >99.7% nucleotide homology, and all the viral genes except for PB1 were highly related to those of A/red-necked stint/Australia/1/04. Thus, the isolates were regarded as PB1 reassortants. The most similar PB1 gene was identified in A/mallard/New Zealand/1615-17/04 (H4N6) with nucleotide homology of 90.9%. BALB/c mice intranasally inoculated with the H4N8 isolates developed severe respiratory disease, which eventually led to death in some mice. Virus was isolated from the lungs, and viral antigen was detected in the lungs with pneumonia. Other H4 subtype viruses tested did not cause any symptoms in mice, although these viruses were also isolated from the lungs. The PB2 gene of the H4N8 isolates contains K482R, but not the E627K or D701N substitutions. The PB1-F2 gene of the isolates consists of a 101-amino acid unique sequence, but lacks the N66S mutation. PMID:22192630

Bui, Vuong N.; Ogawa, Haruko; Xininigen; Karibe, Kazuji; Matsuo, Kengo; Awad, Sanaa S. A.; Minoungou, Germaine L.; Yoden, Satoshi; Haneda, Hiroaki; Ngo, Lai H.; Tamaki, Shio; Yamamoto, Yu; Nakamura, Kikuyasu; Saito, Keisuke; Watanabe, Yukiko; Runstadler, Jonathan; Huettman, Falk; Happ, George M.; Imai, Kunitoshi

2011-01-01

300

Hypoxia, not hypercapnia, induces cardiorespiratory failure in rats.  

PubMed

Mechanical respiratory loads induce cardiorespiratory failure, presumably by increasing O2 demand concurrently with decreases in O2 availability (decreased PaO2). We tested the hypothesis that asphyxia alone can cause cardiorespiratory failure ("failure") in pentobarbital-anesthetized rats. We also tested the hypothesis that hypoxia, not hypercapnia, is responsible by supplying supplemental O2 during mechanical loading in a separate group of rats. Asphyxia (mean PaO2 and PaCO2 of 43 and 69mmHg, respectively) resulted in failure, evident as a slowing of mean respiratory frequency (133-83breaths/min) and a sudden and large drop in mean arterial pressure (71-47mmHg), after 214±66min (n=16; range 117-355min). Neither respiratory drive nor heart rate decreased, indicating that failure was peripheral, not central. Of 8 rats tested after 3h of asphyxia for the presence in blood of cardiac troponin T, all were positive. In an additional 6 rats, normocapnic hypoxia (mean PaCO2 and PaO2 were 39±2.2 and 41±3.1mmHg, respectively) caused failure after an average 205min (range 181-275min), no different from that of asphyxic rats. In the 6 rats that breathed O2 during an initially moderate inspiratory resistive load, endurances exceeded 7h (failure occurring only because we increased the load after 6h) and tracheal pressure and left ventricular dP/dt were maintained despite supercarbia (PaCO2>150mmHg). Thus, asphyxia alone can induce failure, the failure is due to hypoxia, not hypercapnia, and hypercapnia has minimal effects on cardiac and respiratory muscle function in the presence of hyperoxia. PMID:24566393

Simpson, J A; Iscoe, S

2014-06-01

301

Malfunctioning of the Iron-Sulfur Cluster Assembly Machinery in Saccharomyces cerevisiae Produces Oxidative Stress via an Iron-Dependent Mechanism, Causing Dysfunction in Respiratory Complexes  

PubMed Central

Biogenesis and recycling of iron–sulfur (Fe–S) clusters play important roles in the iron homeostasis mechanisms involved in mitochondrial function. In Saccharomyces cerevisiae, the Fe–S clusters are assembled into apoproteins by the iron–sulfur cluster machinery (ISC). The aim of the present study was to determine the effects of ISC gene deletion and consequent iron release under oxidative stress conditions on mitochondrial functionality in S. cerevisiae. Reactive oxygen species (ROS) generation, caused by H2O2, menadione, or ethanol, was associated with a loss of iron homeostasis and exacerbated by ISC system dysfunction. ISC mutants showed increased free Fe2+ content, exacerbated by ROS-inducers, causing an increase in ROS, which was decreased by the addition of an iron chelator. Our study suggests that the increment in free Fe2+ associated with ROS generation may have originated from mitochondria, probably Fe–S cluster proteins, under both normal and oxidative stress conditions, suggesting that Fe–S cluster anabolism is affected. Raman spectroscopy analysis and immunoblotting indicated that in mitochondria from SSQ1 and ISA1 mutants, the content of [Fe–S] centers was decreased, as was formation of Rieske protein-dependent supercomplex III2IV2, but this was not observed in the iron-deficient ATX1 and MRS4 mutants. In addition, the activity of complexes II and IV from the electron transport chain (ETC) was impaired or totally abolished in SSQ1 and ISA1 mutants. These results confirm that the ISC system plays important roles in iron homeostasis, ROS stress, and in assembly of supercomplexes III2IV2 and III2IV1, thus affecting the functionality of the respiratory chain. PMID:25356756

Gomez, Mauricio; Perez-Gallardo, Rocio V.; Sanchez, Luis A.; Diaz-Perez, Alma L.; Cortes-Rojo, Christian; Meza Carmen, Victor; Saavedra-Molina, Alfredo; Lara-Romero, Javier; Jimenez-Sandoval, Sergio; Rodriguez, Francisco; Rodriguez-Zavala, Jose S.; Campos-Garcia, Jesus

2014-01-01

302

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.

2014-08-01

303

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

304

Bovine respiratory coronavirus.  

PubMed

Bovine coronaviruses (BCoVs) cause respiratory and enteric infections in cattle and wild ruminants. BCoV is a pneumoenteric virus that infects the upper and lower respiratory tract and intestine. It is shed in feces and nasal secretions and also infects the lung. BCoV is the cause of 3 distinct clinical syndromes in cattle: (1) calf diarrhea, (2) winter dysentery with hemorrhagic diarrhea in adults, and (3) respiratory infections in cattle of various ages including the bovine respiratory disease complex or shipping fever of feedlot cattle. No consistent antigenic or genetic markers have been identified to discriminate BCoVs from the different clinical syndromes. At present, there are no BCoV vaccines to prevent respiratory BCoV infections in cattle, and the correlates of immunity to respiratory BCoV infections are unknown. This article focuses on respiratory BCoV infections including viral characteristics; epidemiology and interspecies transmission; diagnosis, pathogenesis, and clinical signs; and immunity and vaccines. PMID:20619189

Saif, Linda J

2010-07-01

305

Toward a comprehensive framework of the causes of knowledge management success or failure. A comparative case study  

Microsoft Academic Search

Knowledge management (KM) initiatives have been implemented with diverse results in many organizations. Although there has been substantial inquiry into the conditions for KM success or failure, prior findings need careful systematization before engaging into rigorous empirical inves- tigation. Theory development is still emergent; interesting ideas can be found dispersedly, but signs of comprehensive, convergent theory are rather weak. Thus,

Victor Oltra

306

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

307

FUNCTIONS OF THE RESPIRATORY SYNCYTIAL VIRUS SH AND P PROTEINS.  

E-print Network

??Respiratory syncytial virus (RSV) is the leading cause of pediatric hospitalizations due to lower respiratory tract infections. Immunocompromised and elderly patients can also develop severe… (more)

Fuentes, Sandra

2010-01-01

308

[Heart failure].  

PubMed

It seems that the causes of the insomnia are dyspnea and an orthopnea in the heart failure patient. But, only such a fit is not the cause of the insomnia because it complains about the insomnia even if heart failure is slight. An obstructive sleep apnea (OSA) is the risk of the heart failure. A heart failure patient often complicates a central sleep apnea (CSA) and a Cheyne-Stokes respiration (CSR), and has much sleep fragmentation and difficulty maintaining sleep. And sleep disorders are sometimes started by the medications such as the cardiovascular system agent thing; beta blocker and the statins. Sleep disorders represent a major challenge in terms of differential diagnosis in heart failure patients. This is particularly relevant to insomnia and sleep disordered breathing (SDB) such as OSA, CSA and CSR. Thus, expending the knowledge on both insomnia and SDB may contribute to improve medical quality among physician. PMID:19768933

Sasanabe, Ryujiro; Shiomi, Toshiaki

2009-08-01

309

The effects of mechanical ventilation on the development of Acute Respiratory Distress Syndrome  

E-print Network

Acute Respiratory Distress Syndrome (ARDS) is a severe lung illness characterized by inflammation and fluid accumulation in the respiratory system. Historically, ARDS and other forms of respiratory failure have been treated ...

Jia, Xiaoming, M. Eng. Massachusetts Institute of Technology

2007-01-01

310

The acute effect of bi-level positive airway pressure on heart rate variability in chronic obstructive pulmonary disease patients with hypercapnic respiratory failure Hiperkapnik solunum yetmezlii olan kronik obstrüktif akcier hastalar›nda noninvazif mekanik ventilasyonun kalp h›z› deiflkenlii üzerine olan akut etkisi  

Microsoft Academic Search

Objective: Non-invasive mechanical ventilation (NIMV) has the potential to improve sympathovagal control of heart rate. The aim of this study was to investigate the acute effects of NIMV on heart rate variability (HRV) in chronic obstructive pulmonary disease (COPD) patients with hypercapnic respiratory failure (HRF). Methods: In this prospective study 28 COPD patients (64±10 years) with HRF underwent electrocardiographic Holter

Mehmet Yaz; Kürflat Uzun; Mehmet S; Turgut Teke; Emin Maden; Mehmet Kayrak

311

Managing Feelings about Heart Failure  

MedlinePLUS

... About Heart Failure Module 6: Managing Feelings About Heart Failure Download Module Order Hardcopy Heart failure can cause ... professional help for emotional problems. Common Feelings About Heart Failure It is common for people to feel depressed ...

312

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

313

Thrombospondin-1 deficiency causes a shift from fibroproliferative to inflammatory kidney disease and delays onset of renal failure.  

PubMed

Thrombospondin-1 (TSP1) is a multifunctional matricellular protein known to promote progression of chronic kidney disease. To gain insight into the underlying mechanisms through which TSP1 accelerates chronic kidney disease, we compared disease progression in Col4a3 knockout (KO) mice, which develop spontaneous kidney failure, with that of Col4a3;Tsp1 double-knockout (DKO) mice. Decline of excretory renal function was significantly delayed in the absence of TSP1. Although Col4a3;Tsp1 DKO mice did progress toward end-stage renal failure, their kidneys exhibited distinct histopathological lesions, compared with creatinine level-matched Col4a3 KO mice. Although kidneys of both Col4a3 KO and Col4a3;Tsp1 DKO mice exhibited a widened tubulointerstitium, predominant lesions in Col4a3 KO kidneys were collagen deposition and fibroblast accumulation, whereas in Col4a3;Tsp1 DKO kidney inflammation was predominant, with less collagen deposition. Altered disease progression correlated with impaired activation of transforming growth factor-?1 (TGF-?1) in vivo and in vitro in the absence of TSP1. In summary, our findings suggest that TSP1 contributes to progression of chronic kidney disease by catalyzing activation of latent TGF-?1, resulting in promotion of a fibroproliferative response over an inflammatory response. Furthermore, the findings suggest that fibroproliferative and inflammatory lesions are independent entities, both of which contribute to decline of renal function. PMID:25111226

Zeisberg, Michael; Tampe, Björn; LeBleu, Valerie; Tampe, Desiree; Zeisberg, Elisabeth M; Kalluri, Raghu

2014-10-01

314

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

315

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

316

Preventing Renal Transplant Failure  

Microsoft Academic Search

Abstract Introduction: Allograft failure due to immunological or non-immunological causes or a combination and patient death after transplantation are the 2 major causes of renal transplant loss. This paper reviews the various causes of allograft failure and explores strategies for its prevention. Results: Immune mechanisms of renal allograft failure are those mediated by acute and chronic rejection and are initiated

A Vathsala

2005-01-01

317

Stress Analysis and Testing at the Marshall Space Flight Center to Study Cause and Corrective Action of Space Shuttle External Tank Stringer Failures  

NASA Technical Reports Server (NTRS)

After the launch scrub of Space Shuttle mission STS-133 on November 5, 2010, large cracks were discovered in two of the External Tank intertank stringers. The NASA Marshall Space Flight Center, as managing center for the External Tank Project, coordinated the ensuing failure investigation and repair activities with several organizations, including the manufacturer, Lockheed Martin. To support the investigation, the Marshall Space Flight Center formed an ad-hoc stress analysis team to complement the efforts of Lockheed Martin. The team undertook six major efforts to analyze or test the structural behavior of the stringers. Extensive finite element modeling was performed to characterize the local stresses in the stringers near the region of failure. Data from a full-scale tanking test and from several subcomponent static load tests were used to confirm the analytical conclusions. The analysis and test activities of the team are summarized. The root cause of the stringer failures and the flight readiness rationale for the repairs that were implemented are discussed.

Wingate, Robert J.

2012-01-01

318

320 NATURE MEDICINE VOLUME 5 NUMBER 3 MARCH 1999 Heart failure is a leading cause of cardiovascular mortality in the  

E-print Network

of cardiovascular mortality in the US and Europe1­3 and is a `hallmark' of dilated cardiomyopathy, a multifactorial dystrophy8 cause cardiomyopathy9 . X-linked dilated cardiomyopathy can occur because of mutations in a family with hereditary dilated cardiomyopathy13 . Moreover, metavinculin14 and -sarcoglycan15

Campbell, Kevin P.

319

Respiratory System  

NSDL National Science Digital Library

The purpose, components, and functions of the respiratory system are presented in this learning through disussion and visualizations. Participants learn about the nasal cavity, pharynx, larynx, trachea, bronchi, bronchioles, and alveoli.

Bidlack, Jim

320

Failure of High-Dose Daptomycin for Bacteremia Caused by Daptomycin-Susceptible Enterococcus faecium Harboring LiaSR Substitutions.  

PubMed

High-dose daptomycin (DAP) therapy failed in a neutropenic patient with bloodstream infection caused by a DAP-susceptible Enterococcus faecium (minimum inhibitory concentration, 3 µg/mL) harboring genetic changes associated with DAP resistance, with persistent bacteremia and selection of additional resistances. Daptomycin monotherapy should be used cautiously against DAP-susceptible E. faecium strains with minimum inhibitory concentrations >2 µg/mL. PMID:25107294

Munita, Jose M; Mishra, Nagendra N; Alvarez, Danya; Tran, Truc T; Diaz, Lorena; Panesso, Diana; Reyes, Jinnethe; Murray, Barbara E; Adachi, Javier A; Bayer, Arnold S; Arias, Cesar A

2014-11-01

321

A Chimeric A2 Strain of Respiratory Syncytial Virus (RSV) with the Fusion Protein of RSV Strain Line 19 Exhibits Enhanced Viral Load, Mucus, and Airway Dysfunction  

Microsoft Academic Search

Respiratory syncytial virus (RSV) is the leading cause of respiratory failure and viral death in infants. Abundant airway mucus contributes to airway obstruction in RSV disease. Interleukin-13 (IL-13) is a mediator of pulmonary mucus secretion. It has been shown that infection of BALB\\/c mice with the RSV line 19 strain but not with the RSV A2 laboratory strain results in

Martin L. Moore; Michael H. Chi; Cindy Luongo; Nicholas W. Lukacs; Vasiliy V. Polosukhin; Matthew M. Huckabee; Dawn C. Newcomb; Ursula J. Buchholz; James E. Crowe; K. Goleniewska; J. V. Williams; P. L. Collins; R. S. Peebles

2009-01-01

322

Failures in Mitochondrial tRNAMet and tRNAGln Metabolism Caused by the Novel 4401A>G Mutation Are Involved in Essential Hypertension in a Han Chinese Family  

PubMed Central

We report here on the clinical, genetic, and molecular characterization of 1 Han Chinese family with maternally transmitted hypertension. Three of 7 matrilineal relatives in this 4-generation family exhibited the variable degree of essential hypertension at the age at onset, ranging from 35 to 60 years old. Sequence analysis of the complete mitochondrial DNA in this pedigree identified the novel homoplasmic 4401A>G mutation localizing at the spacer immediately to the 5? end of tRNAMet and tRNAGln genes and 39 other variants belonging to the Asian haplogroup C. The 4401A>G mutation was absent in 242 Han Chinese controls. Approximately 30% reductions in the steady-state levels of tRNAMet and tRNAGln were observed in 2 lymphoblastoid cell lines carrying the 4401A>G mutation compared with 2 control cell lines lacking this mutation. Failures in mitochondrial metabolism are apparently a primary contributor to the reduced rate of mitochondrial translation and reductions in the rate of overall respiratory capacity, malate/glutamate-promoted respiration, succinate/glycerol-3-phosphate–promoted respiration, or N,N,N?,N?-tetramethyl-p-phenylenediamine/ascorbate-promoted respiration in lymphoblastoid cell lines carrying the 4401A>G mutation. The homoplasmic form, mild biochemical defect, late onset, and incomplete penetrance of hypertension in this family suggest that the 4401A>G mutation itself is insufficient to produce a clinical phenotype. Thus, the other modifier factors, eg, nuclear modifier genes and environmental and personal factors, may also contribute to the development of hypertension in these subjects carrying this mutation. These data suggest that mitochondrial dysfunctions, caused by the 4401A>G mutation, are involved in the development of hypertension in this Chinese pedigree. PMID:19546379

Li, Ronghua; Liu, Yuqi; Li, Zongbin; Yang, Li; Wang, Shiwen; Guan, Min-Xin

2010-01-01

323

Acute respiratory distress syndrome following cutaneous exposure to Lysol: a case report.  

PubMed

Lysol (mixed cresols) is a brand of popular detergent commonly used to disinfect toilets and floors in Taiwan. We report a patient with acute respiratory failure immediately following chemical burns caused by skin contact with Lysol solution. On admission, chest radiography showed bilateral diffuse pulmonary infiltrates and an arterial blood gas analysis disclosed hypoxemia refractory to a high concentration of oxygen by inhalation. Under the impression of acute respiratory distress syndrome, our patient was admitted to the intensive care unit for respiratory care. Poor clinical improvement was noted, despite aggressive respiratory therapy. High-dose steroid therapy (hydrocortisone 30 mg/kg/day) was administered from the seventh day after mechanical ventilation began and the ratio of arterial partial pressure of oxygen to fractional concentration of oxygen in inspired gas improved thereafter. The amount of steroid was gradually tapered to the maintenance dose and the patient was successfully weaned from the ventilator after a 93-day course of mechanical ventilation. PMID:10634006

Liu, Y Y; Lu, C C; Perng, R P

1999-12-01

324

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

325

Bovine Respiratory Disease Max Irsik DVM, MAB  

E-print Network

to an extension of infection from the upper respiratory tract or a failure of the mechanisms designed to protect of Florida College of Veterinary Medicine Disease of the respiratory tract is a major problem for cattle does not develop. However under stress the animal's defense mechanisms may be overcome and an infection

Watson, Craig A.

326

Vaccine-Induced Immunopathology during Bovine Respiratory Syncytial Virus Infection: Exploring the Parameters of Pathogenesis  

PubMed Central

The bovine and human respiratory syncytial viruses cause severe lower respiratory tract infections. Effective vaccines against the respiratory syncytial viruses have been lacking since vaccine failures in the 1960s and 1970s. In this report, we describe a bovine respiratory syncytial virus (bRSV) challenge model in which both classical bRSV respiratory infection and vaccine-enhanced immune pathology were reproduced. The classical, formalin-inactivated (FI) bRSV vaccine that has been associated with vaccine failure was efficient in inducing high antibody titers and reducing viral loads but also primed calves for a far more serious enhanced respiratory disease after a bRSV challenge, thereby mimicking the enhanced clinical situation in FI human RSV (hRSV)-immunized and hRSV-infected infants in the 1960s. We show that immunization with FI-bRSV mainly primes a Th2-like inflammatory response that is characterized by a significant eosinophilic influx in the bronchial alveolar lung fluid and lung tissues and high levels of immunoglobulin E serum antibodies. The current model may be useful in the evaluation of new bRSV candidate vaccines for potency and safety. PMID:14581543

Antonis, Adriaan F. G.; Schrijver, Remco S.; Daus, Franz; Steverink, Paul J. G. M.; Stockhofe, Norbert; Hensen, Evert J.; Langedijk, Johannes P. M.; van der Most, Robbert G.

2003-01-01

327

Equine respiratory pharmacology.  

PubMed

Differentiation of diseases of the equine respiratory tract is based on history, clinical signs, auscultation, endoscopy, imaging, and sampling of airway exudate. Upper respiratory therapies include surgical correction of airway obstructions; flushing of localized abscesses (strangles), guttural pouch disease, or sinusitis; and oral or parenteral antibiotic and anti-inflammatory therapy if deemed necessary. Pneumonia usually is treated with antimicrobials, anti-inflammatories, and bronchodilators. Pleural drainage is indicated if significant pleural effusion is present. The most commonly used therapies for early inflammatory and chronic allergic obstructive conditions include bronchodilators and anti-inflammatories. Acute respiratory distress, particularly acute pulmonary edema, is treated with diuretics (usually furosemide), intranasal oxygen, bronchodilators, corticosteroids, and alleviation of the underlying cause. Furosemide also had been used in North America as a race-day preventative for exercise-induced pulmonary hemorrhage (EIPH), but recent data have shown that furosemide may be a performance-enhancing agent itself. PMID:10589473

Foreman, J H

1999-12-01

328

Air quality models and unusually large ozone increases: Identifying model failures, understanding environmental causes, and improving modeled chemistry  

NASA Astrophysics Data System (ADS)

Several factors combine to make ozone (O3) pollution in Houston, Texas, unique when compared to other metropolitan areas. These include complex meteorology, intense clustering of industrial activity, and significant precursor emissions from the heavily urbanized eight-county area. Decades of air pollution research have borne out two different causes, or conceptual models, of O 3 formation. One conceptual model describes a gradual region-wide increase in O3 concentrations "typical" of many large U.S. cities. The other conceptual model links episodic emissions of volatile organic compounds to spatially limited plumes of high O3, which lead to large hourly increases that have exceeded 100 parts per billion (ppb) per hour. These large hourly increases are known to lead to violations of the federal O 3 standard and impact Houston's status as a non-attainment area. There is a need to further understand and characterize the causes of peak O 3 levels in Houston and simulate them correctly so that environmental regulators can find the most cost-effective pollution controls. This work provides a detailed understanding of unusually large O 3 increases in the natural and modeled environments. First, we probe regulatory model simulations and assess their ability to reproduce the observed phenomenon. As configured for the purpose of demonstrating future attainment of the O3 standard, the model fails to predict the spatially limited O3 plumes observed in Houston. Second, we combine ambient meteorological and pollutant measurement data to identify the most likely geographic origins and preconditions of the concentrated O3 plumes. We find evidence that the O3 plumes are the result of photochemical activity accelerated by industrial emissions. And, third, we implement changes to the modeled chemistry to add missing formation mechanisms of nitrous acid, which is an important radical precursor. Radicals control the chemical reactivity of atmospheric systems, and perturbations to radical budgets can shift chemical pathways. The mechanism additions increase the concentrations of nitrous acid, especially right after sunrise. The overall effect on O3 is small (up to three ppb), but we demonstrate the successful implementation of a surface sub-model that chemically processes adsorbed compounds. To our knowledge, this is the first time that chemical processing on surfaces has been used in a three-dimensional regulatory air quality model.

Couzo, Evan A.

329

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

330

Relation of digoxin use in atrial fibrillation and the risk of all-cause mortality in patients ?65 years of age with versus without heart failure.  

PubMed

Previous studies on digoxin use in patients with atrial fibrillation (AF) and the risk of all-cause mortality found conflicting results. We conducted a population-based, retrospective, cohort study of patients aged ?65 years admitted to a hospital with a primary or secondary diagnosis of AF, in Quebec province, Canada, from 1998 to 2012. The AF cohort was grouped into patients with and without heart failure (HF) and into digoxin and no-digoxin users according to the first prescription filled for digoxin within 30 days after AF hospital discharge. We derived propensity score-matched digoxin and no-digoxin treatment groups for the groups of patients with and without HF, respectively, and conducted multivariable Cox proportional hazards regression analyses to determine association between digoxin use and all-cause mortality. The AF propensity score-matched cohorts of patients with and without HF were well balanced on baseline characteristics. In the propensity score-matched HF group, digoxin use was associated with a 14% greater risk of all-cause mortality (adjusted hazard ratio 1.14, 95% confidence interval 1.10 to 1.17). In the propensity score-matched no-HF group, digoxin use was associated with a 17% greater risk of all-cause mortality (adjusted hazard ratio 1.17, 95% confidence interval 1.14 to 1.19). In conclusion, our retrospective analyses found that digoxin use was associated with a greater risk for all-cause mortality in patients aged ?65 years with AF regardless of concomitant HF. Large, multicenter, randomized controlled trials or prospective cohort studies are required to clarify this issue. PMID:24950677

Shah, Mitesh; Avgil Tsadok, Meytal; Jackevicius, Cynthia A; Essebag, Vidal; Behlouli, Hassan; Pilote, Louise

2014-08-01

331

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

332

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

333

Zipingpu Concrete Face Rockfill Dam Failures caused by the 8.0R Earthquake on the 12th May 2008 (Chengdu, China)  

NASA Astrophysics Data System (ADS)

The 8.0R earthquake that struck Sichuan on the 12th of May 2008, in the district of Chengdu of Southern China resulted in tenths of thousands casualties, the complete destruction of many towns and extended damages to public works. The earthquake was triggered by a reverse fault of NE-SW trend, more than 100 km long, that divides morphologically the affected area in two sections, the eastern one with mild low topography and the western one with intense relief representing the boundary of Tibet Mountains. This mountainous section is characterized by a rich drainage network that drains the greater region of the Tibet plateau. Along the trace of this high-stand for thousands of years numerous hydraulic works have been attempted in order to manage the water supply. Especially during the past decades, 400 small and large dams have been constructed. The main dam is the Zipingpu dam. It is a Concrete Face Rockfill Dam (CFRD) that has a height of 150m, a capacity of 1.2 billion m3 and includes a hydroelectric plant of 3.4 billion Kwh power. The Zipingpu dam is located 10km east of the earthquake epicenter and after the earthquake of 8.0R, the following failures were recorded: (i) Subsidence of the crown in the central part of the dam, of the order of 50cm in relation to the side survey control points, (ii) Deformation of the lower face of the dam, an area of approximately 1000 m2, (iii) Deviations and deformations of the construction elements throughout the face of the dam, (iv) Widening of construction joints (approximately 15 cm on the upper face), (v) Extended massive landslides throughout the reservoir, and (vi) Landslides on both left and right abutments of the dam causing further damages to secondary constructions. After the evaluation of the dam damages, the discharge of the reservoir was ordered through the emergency spillway in order to minimize the risk of a potential disaster for the nearby towns and especially Dujiangyan. Finally, the causes of the failures are investigated based on the available data.

Lekkas, E.

2009-04-01

334

Refractory cardiopulmonary failure after glyphosate surfactant intoxication: a case report  

PubMed Central

Background Glyphosate is an herbicide considered to be of low toxicity to humans because its effects are specific to plants. However, fatal reactions to glyphosate have been reported after the ingestion of large amounts. Pulmonary edema, shock, and arrhythmia were the reported causes of mortality. Case presentation We present the case of a 57-year-old woman who was admitted to the emergency department unconsciousness after ingestion of glyphosate surfactant in a suicide attempt. Metabolic acidosis, refractory respiratory failure, and shock developed during hospitalization. Despite aggressive supportive care, the patient died in the hospital. Conclusion The toxicokinetics of glyphosate surfactant is complicated. Respiratory failure, metabolic acidosis, tachycardia, elevated creatinine, and hyperkalemia are poor prognostic factors if presented. Physicians should consider using hemodialysis early to improve the outcome of patients with glyphosate surfactant intoxication. PMID:19178755

Chang, Chirn-Bin; Chang, Chia-Chu

2009-01-01

335

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

336

Dysrhythmias of the respiratory oscillator  

NASA Astrophysics Data System (ADS)

Breathing is regulated by a central neural oscillator that produces rhythmic output to the respiratory muscles. Pathological disturbances in rhythm (dysrhythmias) are observed in the breathing pattern of children and adults with neurological and cardiopulmonary diseases. The mechanisms responsible for genesis of respiratory dysrhythmias are poorly understood. The present studies take a novel approach to this problem. The basic postulate is that the rhythm of the respiratory oscillator can be altered by a variety of stimuli. When the oscillator recovers its rhythm after such perturbations, its phase may be reset relative to the original rhythm. The amount of phase resetting is dependent upon stimulus parameters and the level of respiratory drive. The long-range hypothesis is that respiratory dysrhythmias can be induced by stimuli that impinge upon or arise within the respiratory oscillator with certain combinations of strength and timing relative to the respiratory cycle. Animal studies were performed in anesthetized or decerebrate preparations. Neural respiratory rhythmicity is represented by phrenic nerve activity, allowing use of open-loop experimental conditions which avoid negative chemical feedback associated with changes in ventilation. In animal experiments, respiratory dysrhythmias can be induced by stimuli having specific combinations of strength and timing. Newborn animals readily exhibit spontaneous dysrhythmias which become more prominent at lower respiratory drives. In human subjects, swallowing was studied as a physiological perturbation of respiratory rhythm, causing a pattern of phase resetting that is characterized topologically as type 0. Computational studies of the Bonhoeffer-van der Pol (BvP) equations, whose qualitative behavior is representative of many excitable systems, supports a unified interpretation of these experimental findings. Rhythmicity is observed when the BvP model exhibits recurrent periods of excitation alternating with refractory periods. The same system can be perturbed to a state in which amplitude of oscillation is attenuated or abolished. We have characterized critical perturbations which induce transitions between these two states, giving rise to patterns of dysrhythmic activity that are similar to those seen in the experiments. We illustrate the importance of noise in initiation and termination of rhythm, comparable to normal respiratory rhythm intermixed with spontaneous dysrhythmias. In the BvP system the incidence and duration of dysrhythmia is shown to be strongly influenced by the level of noise. These studies should lead to greater understanding of rhythmicity and integrative responses of the respiratory control system, and provide insight into disturbances in control mechanisms that cause apnea and aspiration in clinical disease states.

Paydarfar, David; Buerkel, Daniel M.

1995-03-01

337

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

338

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

339

Survival and echocardiographic data in dogs with congestive heart failure caused by mitral valve disease and treated by multiple drugs: A retrospective study of 21 cases  

PubMed Central

This retrospective study reports the survival time [onset of congestive heart failure (CHF) to death from any cause] of 21 dogs with mitral regurgitation (MR) and CHF treated with a combination of furosemide, angiotensin-converting enzyme inhibitor (ACEI, benazepril, or enalapril), pimobendan, spironolactone, and amlodipine. Baseline echocardiographic data: end-systolic and end-diastolic volume indices (ESVI and EDVI), left atrium to aorta ratio (LA/Ao), and regurgitant fraction (RF) are reported. Median survival time (MST) was 430 d. Initial dosage of furosemide (P = 0.0081) and LA/Ao (P = 0.042) were negatively associated with survival. Baseline echocardiographic indices (mean ± standard deviation) were 40.24 ± 16.76 for ESVI, 161.48 ± 44.49 mL/m2 for EDVI, 2.11 ± 0.75 for LA/Ao, and 64.71 ± 16.85% for RF. Combining furosemide, ACEI, pimobendan, spironolactone, and amlodipine may result in long survival times in dogs with MR and CHF. Severity of MR at onset of CHF is at least moderate. PMID:22547843

de Madron, Eric; King, Jonathan N.; Strehlau, Gunther; White, Regina Valle

2011-01-01

340

Two Pharmacodynamic Models for Assessing the Efficacy of Amoxicillin-Clavulanate against Experimental Respiratory Tract Infections Caused by Strains of Streptococcus pneumoniae  

PubMed Central

Two models of respiratory tract infection were used to investigate the pharmacodynamics of amoxicillin-clavulanate against Streptococcus pneumoniae. Eight strains of S. pneumoniae were used in a mouse model in which the animals were infected intranasally and were then treated with a range of doses and dose intervals. The time that the plasma amoxicillin concentration remained above the MIC (T>MIC) correlated well with bacterial killing, such that if T>MIC was below 20% there was no effect on bacterial numbers in the lungs. As T>MIC increased, the response, in terms of decreased bacterial load, improved and at T>MICs of greater than 35 to 40% of the dosing interval, bacteriological cure was maximal. On the basis of equivalent T>MICs, these data would suggest that in humans a dosage of 500 mg three times daily (t.i.d.) should have efficacy equal to that of a dosage of 875 mg twice daily (b.i.d.). This hypothesis was evaluated in a rat model in which amoxicillin-clavulanate was given by computer-controlled intravenous infusion to achieve concentrations that approximate the concentrations achieved in the plasma of humans following oral administration of 500/125 mg t.i.d. or 875/125 mg b.i.d. Infusions continued for 3 days and bacterial numbers in the lungs 2 h after the cessation of the infusion were significantly reduced (P < 0.01) by both treatments in strains of S. pneumoniae for which amoxicillin MICs were below 2 ?g/ml. When tested against a strain of S. pneumoniae for which the amoxicillin MIC was 4 ?g/ml, the simulated 500/125-mg dose was ineffective but the 875/125-mg dose demonstrated a small but significant (P < 0.01) reduction in bacterial numbers. These data confirm the findings in the mouse and indicate that amoxicillin-clavulanate administered at 875/125 mg b.i.d. would be as effective clinically as amoxicillin-clavulanate administered at 500/125 mg t.i.d. PMID:9869561

Woodnutt, Gary; Berry, Valerie

1999-01-01

341

What causes an icy fault to slip? Investigating the depth and frictional conditions for tidally driven Coulomb failure along major strike-slip faults of Europa and Ganymede  

NASA Astrophysics Data System (ADS)

The surfaces of Europa and Ganymede display strike-slip fractures, presumably arising from a combination of global and local stress sources. To better understand the role of tidal stress sources and implications for strike-slip faulting on these icy bodies, we investigate the relationship between shear and normal stresses at several major fault zones: Agenor Linea, Rhadamanthys Linea, Agave/Asterius Lineae, and Astypalaea Linea (on Europa), and Dardanus Sulcus (on Ganymede). Assuming tidal diurnal and non-synchronous rotation (NSR) stresses as plausible mechanisms for strike-slip tectonism, here we investigate the mechanics of Coulomb shear failure. We consider a range of friction coefficients (µf = 0.2 – 0.6) and fault depths (0 – 6 km) to evaluate how failure predictions vary between the satellites and as a function of depth, ice friction, geographic location, and fault geometry. Assuming present-day orbital eccentricities, our results indicate that the conditions for failure at depth are not met for any of the fault systems if subject to diurnal stresses only. Alternatively, models that include both diurnal and NSR stresses readily generate stress magnitudes that could permit shear failure. On Europa, shear failure is easily activated and failure extends to depths ranging from 3 – 6 km when a low coefficient of friction (µf = 0.2) is assumed. On Ganymede, failure is limited to even shallower depths (< 2 km). A high coefficient of friction (µf = 0.6) limits failure depths to < 3 km on Europa faults and discourages strike-slip faulting completely on Ganymede. Based on these results, we infer that the conditions for shear failure are potentially met along at least these five studied systems, and possibly others in the outer solar system, if NSR is adopted as a driving stress mechanism and the coefficient of friction is low.

Cameron, Marissa E.; Smith-Konter, Bridget R.; Pappalardo, Robert T.

2014-11-01

342

Acute respiratory infections: the forgotten pandemic. Communiqué from the International Conference on Acute Respiratory Infections, held in Canberra, Australia, 7-10 July 1997.  

PubMed

Acute respiratory infections kill 4 million children every year in developing countries, and most of these deaths are caused by pneumonia. This huge loss of life goes virtually unnoticed, despite the fact that we have two very effective ways of preventing many of the deaths from pneumonia: Haemophilus influenzae type b vaccine, and standardised antibiotic treatment regimens. Although H. influenzae type b vaccine has virtually eliminated diseases caused by this organism in children in developed countries, failure to appreciate the importance of this organism and the high cost of the vaccine has meant that it has not been used in developing countries; urgent steps need to be taken to ensure that children in developing countries receive H. influenzae vaccine. Streptococcus pneumoniae is a major cause of fatal pneumonia in developing countries. Controlled trials are needed to define the role of unconjugated 23-valent S. pneumoniae vaccine, and the new conjugate vaccine must be made available to children in developing countries soon after it is licensed. The World Health Organization has developed simple and effective guidelines for the treatment of pneumonia which have been incorporated into its Integrated Management of Childhood Illness strategy, and this programme should be strongly supported. In developed countries, acute respiratory infections are the leading cause of morbidity. The cost of these infections is enormous, because of lost earnings and the cost of treatment. There is an urgent need for systematic evaluation of existing knowledge about acute respiratory infections in developed countries, so that this knowledge can be applied to prevention and treatment. Approximately 75% of antibiotics are prescribed for acute respiratory infections, and many of these prescriptions are unnecessary. Unnecessary use of antibiotics is very expensive, and it has contributed to the rapid increase in resistance which has already made some bacteria resistant to all antibiotics. Rational guidelines for antibiotic prescribing need to be developed, and steps taken to see that they are followed. There should be greatly increased use of the existing influenza and pneumococcal vaccines in high risk groups in developed countries. New vaccines against pertussis, S. pneumoniae, non-serotypable H. influenzae, and respiratory syncytial virus have been developed and need to be carefully evaluated. Acute respiratory infections are responsible for 8.2% of the world's total burden of disability and premature death, but they receive only 0.15% of the research and development budget for health. More resources should be allocated to research on acute respiratory infections. Drug therapy has little effect on the course of viral upper respiratory tract infections. Worldwide, US$8 billion is wasted every year on drugs used to treat the symptoms of acute respiratory infections. PMID:9562104

1998-01-01

343

Metallization failures  

NASA Technical Reports Server (NTRS)

Metallization-related failure mechanisms were shown to be a major cause of integrated circuit failures under accelerated stress conditions, as well as in actual use under field operation. The integrated circuit industry is aware of the problem and is attempting to solve it in one of two ways: (1) better understanding of the aluminum system, which is the most widely used metallization material for silicon integrated circuits both as a single level and multilevel metallization, or (2) evaluating alternative metal systems. Aluminum metallization offers many advantages, but also has limitations particularly at elevated temperatures and high current densities. As an alternative, multilayer systems of the general form, silicon device-metal-inorganic insulator-metal, are being considered to produce large scale integrated arrays. The merits and restrictions of metallization systems in current usage and systems under development are defined.

Beatty, R.

1971-01-01

344

Type A intramural hematoma presenting with acute right heart failure caused by compression of the main pulmonary artery: a case report.  

PubMed

Pulmonary artery obstruction is a rare complication of intramural hematoma of the ascending aorta. There were few reported cases presenting with right heart failure due to compression of the pulmonary trunk by intramural hematoma of the aorta. PMID:18809295

Can, Mehmet; Tanboga, Ibrahim H; Akgun, Taylan; Turkyilmaz, Erdem; Aung, Soe M; Yilmaz, Fatih; Kaya, Zekeriya; Boztosun, Bilal; Kaymaz, Cihangir

2009-01-01

345

Rye grains and the soil derived from under the organic and conventional rye crops as a potential source of biological agents causing respiratory diseases in farmers  

PubMed Central

Introduction Introduction: Due to the specific work environment, farmers are exposed to various biological occupational hazard. Among these factors significant are fungi present in the grain and also in the soil. The fungi may be the cause of human diseases including skin infections, asthma, allergic rhinitis and many others. Aim The aim of this study was to quantify and identify species of fungi colonizing rye grain samples and the soil under cultivation. Material and methods The material consisted of grain and soil samples from two agricultural systems: organic and conventional. To determine the concentration and composition of fungi in collected samples, two media: Malt Agar (MA, Becton, Dickinson and Company) and Potato Dextrose Agar (PDA, Becton, Dickinson and Company) were used. The composition of species in fungal flora was determined using macroscopic and microscopic methods. The isolates of fungi were ranked in the appropriate classes of biosafety BSL. Results The most frequently isolated fungi from organic rye grain, regardless of the media used, were species: Aureobasidium pullulans and Alternaria alternata. In conventional farms, most species isolated from rye grain were: Aureobasidium pullulans, Cladosporium oxysporum, Alternaria alternata and yeast-like fungi. Most often species isolated from the soil was Penicillium citreo-viride. Conclusions All the results of the research demonstrate the potential hazard to the health of people working in agriculture. Significant exposure of this professional group is associated with the presence of harmful biological agents present in the grain and soil from its cultivation. PMID:24494000

Cholewa, Grazyna; Krasowska, Ewelina; Chmielewska-Badora, Jolanta; Zwolinski, Jacek; Sobczak, Pawel

2013-01-01

346

Warning Signs of Heart Failure  

MedlinePLUS

Warning Signs of Heart Failure Updated:Jul 18,2014 By themselves, any one sign of heart failure may not be cause for alarm. But ... content was last reviewed on 08/20/2012." Heart Failure • Home • About Heart Failure • Warning Signs of Heart ...

347

Detection of Respiratory Viruses by Molecular Methods  

PubMed Central

Summary: Clinical laboratories historically diagnose seven or eight respiratory virus infections using a combination of techniques including enzyme immunoassay, direct fluorescent antibody staining, cell culture, and nucleic acid amplification tests. With the discovery of six new respiratory viruses since 2000, laboratories are faced with the challenge of detecting up to 19 different viruses that cause acute respiratory disease of both the upper and lower respiratory tracts. The application of nucleic acid amplification technology, particularly multiplex PCR coupled with fluidic or fixed microarrays, provides an important new approach for the detection of multiple respiratory viruses in a single test. These multiplex amplification tests provide a sensitive and comprehensive approach for the diagnosis of respiratory tract infections in individual hospitalized patients and the identification of the etiological agent in outbreaks of respiratory tract infection in the community. This review describes the molecular methods used to detect respiratory viruses and discusses the contribution that molecular testing, especially multiplex PCR, has made to our ability to detect respiratory viruses and to increase our understanding of the roles of various viral agents in acute respiratory disease. PMID:18854489

Mahony, James B.

2008-01-01

348

Mechanisms of illness during respiratory syncytial virus infection: the lungs, the virus and the immune response  

Microsoft Academic Search

Multiple factors, including cardiopulmonary anatomy, direct viral effects and the immune response can affect the severity of lower respiratory tract disease caused by respiratory syncytial virus (RSV). RSV is the most frequent viral respiratory cause of hospitalization in infants and young children in the world. In this review, we discuss the mechanisms of illness associated with severe RSV lower respiratory

Scott J. Hoffman; Federico R. Laham; Fernando P. Polack

2004-01-01

349

Postburn respiratory injuries in children  

SciTech Connect

Respiratory tract injury is a leading cause of mortality, morbidity, and prolonged hospitalization in fire casualties. Direct insults include inhalation of superheated gas, steam, smoke, or toxic fumes. Indirect injury may result from interference with the mechanics of respiration. Pulmonary injuries result from sepsis, fluid overload, endogenous reactive substances, and shock lung, and also occur secondary to metabolic disturbances resulting from hypoxia.

Charnock, E.L.; Meehan, J.J.

1980-08-01

350

An Assessment of the Appropriateness of Respiratory Care Delivered at a 450Bed Acute Care Veterans Affairs Hospital  

Microsoft Academic Search

INTRODUCTION: Respiratory care is expensive and time-intensive, inappropriate care wastes resources, and failure to provide necessary and appropriate respiratory care may adversely affect patient outcomes. OBJECTIVE: To determine the appropriateness of basic respiratory care delivered at a 450-bed Veterans Affairs hospital during a 3-month interval. METHODS: We determined (1) the percentage of delivered respiratory care that was not indicated (based

David C Shelledy; Terry S LeGrand; Jay I Peters

351

Compression syndromes caused by substernal goitres.  

PubMed Central

Enlargement of the thyroid is common, especially in areas of endemic iodine deficiency. Substernal enlargement of a goitre can cause compression of several mediastinal structures. As a consequence of tracheal compression and tracheomalacia, syndromes of chronic respiratory distress occur and intercurrent upper respiratory infections may lead to acute respiratory failure. Superior vena cava syndrome secondary to compression by a substernal goitre may be complicated by venous thrombosis. Although dysphagia is the most frequent oesophageal symptom of a substernal goitre, upper gastrointestinal bleeding from 'downhill' oesophageal varices may be an initial presentation. Arterial compression or thyrocervical steal syndrome by large substernal goitres occasionally cause cerebral hypoperfusion and stroke. Recurrent and phrenic nerve palsies, as well as Horner's syndrome, occur secondary to non-malignant mediastinal goitres and may resolve after surgery. Substernal goitres rarely cause therapy-resistant pleural effusions, chylothorax and pericardial effusion. In conclusion, although cervical goitres are easily recognised, the initial presentation of mainly substernal goitres may be unusual. Images Figure 2 PMID:9799884

Anders, H. J.

1998-01-01

352

Development of Neonatal Respiratory and Intensive Care: Chinese Perspectives  

Microsoft Academic Search

Recent economic improvements in China have allowed the development of perinatal-neonatal care in sub-provincial regions. However, variations in neonatal respiratory and intensive care exist, especially in regions with limited resources. We conducted a series of collaborative clinical investigations into neonatal hypoxemic respiratory failure (NRF). In the study period from 2004 to 2005, this nationwide study found an incidence of NRF

Bo Sun; Li Ma; Xiaohong Liu; Xirong Gao; Liming Ni

2012-01-01

353

Hepatitis during respiratory syncytial virus infection - a case report  

PubMed Central

Introduction: Respiratory syncytial virus (RSV) infection is the most common cause of hospitalization in infants and small children. The aim was to present a 13-months old boy diagnosed with acute airway infection, acute otitis media (AOM) and hepatitis during the RSV-infection. Material and methods: Serum catalytic activities of alkaline phosphatase (ALP), aspartate aminotranspherase (AST), alanine aminotranspherase (ALT), gamma glutamyl transpherase (GGT), lactate dehydrogenase (LD), and concentrations of bilirubin were monitored during hospitalization and at control examination. Results: The child had clinical signs and symptoms of respiratory failure, AOM, and laboratory findings of virus infection and liver disease. On admission, catalytic activities of enzymes were markedly increased, especially the activity of ALP (10333 U/L, i.e. 24-fold increase in comparison with the upper reference limit). The highest increased in AST (339 U/L, 4.5-fold), ALT (475 U/L, 10.3-fold) and LD (545 U/L, 1.5-fold) were registered on the 3rd day, and the highest increase in GGT (68 U/L, 3.1-fold) occurred on the 11th day. Seven weeks after discharge AST, ALT, GGT and LD decreased into reference range, and ALP remain mildly increased (478 U/L, 1.1 fold increase). RSV was confirmed in nasal lavage fluid. Conclusion: Laboratory results in patient with RSV infection needs to be interpreted in the light of both, respiratory and extrapulmonary manifestations of the infection, respectively. PMID:23457772

Kirin, Branka Kristic; Topic, Renata Zrinski; Dodig, Slavica

2013-01-01

354

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  

Microsoft Academic Search

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

Theodoros H. Varzakas; Ioannis S. Arvanitoyannis

2007-01-01

355

Heart Failure  

MedlinePLUS

... version of this page please turn Javascript on. Heart Failure What is Heart Failure? In heart failure, the heart cannot pump ... the lungs, where it picks up oxygen. The Heart's Pumping Action In normal hearts, blood vessels called ...

356

Effect of Zinc Salts on Respiratory Syncytial Virus Replication  

Microsoft Academic Search

Zinc supplementation decreases the morbidity of lower respiratory tract infection in pediatric patients in the developing world. We sought to determine if zinc mediates a specific inhibitory effect against the major cause of pediatric lower respiratory tract disease, respiratory syncytial virus (RSV). We determined the in vitro inhibitory effect of three zinc salts (zinc acetate, lactate, and sulfate) on the

Rahaman O. Suara; James E. Crowe

2004-01-01

357

Integrated approach for in vivo evaluation of respiratory muscles mechanics  

Microsoft Academic Search

The respiratory muscles constitute the respiratory pump, which determines the efficacy of ventilation. Any functional disorder in their performance may cause insufficient ventilation. This study was designed to quantitatively explore the relative contribution of major groups of respiratory muscles to global lung ventilation throughout a range of maneuvers in healthy subjects. A computerized experimental system was developed for simultaneous noninvasive

Anat Ratnovsky; Uri Zaretsky; Robert J. Shiner; David Elad

2003-01-01

358

Heart failure - surgeries and devices  

MedlinePLUS

... Suggested procedures may include: Angioplasty and stent placement Heart bypass surgery ... cause heart failure or make heart failure worse. Heart valve surgery may be needed to repair or replace one ...

359

What Causes COPD?  

MedlinePLUS

... page from the NHLBI on Twitter. What Causes COPD? Long-term exposure to lung irritants that damage ... outcomes Statin therapy does not prevent exacerbations of chronic obstructive pulmonary disease (COPD) or lower mortality from acute respiratory distress ...

360

Failure Assessment  

NASA Technical Reports Server (NTRS)

Three questions to which software developers want accurate, precise answers are "How can the software system fail?", "mat bad things will happen if the software fails?t', and "How many failures will the software experience?". Numerous techniques have been devised to answer these questions; three of the best known are: 1) Software Fault Tree Analysis (SFTA) 2) Software Failure Modes, Effects, and Criticality Analysis (SFMECA 3) Software Fault/Failure Modeling. SFTA and SFMECA have been successfully used to analyze the flight software for a number of robotic planetary exploration missions, including Galileo, Cassini, and Deep Space 1. Given the increasing interest in reusing software components from mission to mission, one of us has developed techniques for reusing the corresponding portions of the SFTA and SFMECA, reducing the effort required to conduct these analyses. SFTA has also been shown to be effective in analyzing the security aspects of software systems; intrusion mechanisms and effects can easily be modeled using these techniques. The Bi- Directional Safety Analysis (BDSA) method combines a forward search (similar to SFMECA) from potential failure modes to their effects, with a backward search (similar to SFTA) from feasible hazards to the contributing causes of each hazard. BDSA offers an efficient way to identify latent failures. Recent work has extended BDSA to product-line applications such as flight-instrumentation displays and developed tool support for the reuse of the failure-analysis artifacts within a product line. BDSA has also been streamlined to support those projects having tight cost and/or schedule constraints for their failure analysis efforts. We discuss lessons learned from practice, describe available tools, and identi@ some future directions for the topic. A substantial amount of research has been devoted to estimating the number of failures that a software system will experience during test and operations, as well as the number of faults that have been inserted into that system during its development. One of us has found that the amount of structural change to a system during its development is strongly related to the number of faults inserted into it. Using techniques requiring no additional effort on the part of the development organization, the required measurements of structural evolution can be easily obtained from a development effort's configuration management system and readily transformed into an estimate of fault content. So far, structure-fault relationships have been identified for source code; current work seeks to examine artifacts available earlier in the lifecycle to determine if similar relationships between structure and fault content can be found. In particular, relationships between requirements change requests and the number of faults inserted into the implemented system would provide a significant improvement in our ability to control software quality during the early development phases.

Lutz, Robyn; Nikora, Allen

2005-01-01

361

[Respiratory treatments in neuromuscular disease].  

PubMed

In a previous article, a review was presented of the respiratory pathophysiology of the patient with neuromuscular disease, as well as their clinical evaluation and the major complications causing pulmonary deterioration. This article presents the respiratory treatments required to preserve lung function in neuromuscular disease as long as possible, as well as in special situations (respiratory infections, spinal curvature surgery, etc.). Special emphasis is made on the use of non-invasive ventilation, which is changing the natural history of many of these diseases. The increase in survival and life expectancy of these children means that they can continue their clinical care in adult units. The transition from pediatric care must be an active, timely and progressive process. It may be slightly stressful for the patient before the adaptation to this new environment, with multidisciplinary care always being maintained. PMID:24890888

Martínez Carrasco, C; Cols Roig, M; Salcedo Posadas, A; Sardon Prado, O; Asensio de la Cruz, O; Torrent Vernetta, A

2014-10-01

362

Reported tailings dam failures  

Microsoft Academic Search

A detailed search and re-evaluation of the known historical cases of tailings dam failure was carried out. A corpus of 147 cases of worldwide tailings dam disasters, from which 26 located in Europe, was compiled in a database. This contains six sections, including dam location, its physical and constructive characteristics, actual and putative failure cause, sludge hydrodynamics, socio-economical consequences and

M. Rico; G. Benito; A. R. Salgueiro; A. D ´ õez-Herrero; H. G. Pereira

2008-01-01

363

Pathogenesis of Respiratory Syncytial Virus Infection in the Murine Model  

Microsoft Academic Search

There is a wide spectrum of illness caused by respiratory syncytial virus (RSV) infection that is caused in large part by host-related factors, such as age of the patient and degree of host immunocom- petency. Although the vast majority of persons infected with RSV experience symptoms of mild upper respiratory tract infection, in some people these infections cause significant morbidity

R. Stokes Peebles; Barney S. Graham

2005-01-01

364

Periprosthetic fracture of the tibia associated with osteolysis caused by failure of rotating patella in low-contact–stress total knee arthroplasty  

Microsoft Academic Search

Periprosthetic fracture of the tibial plateau associated with osteolysis resulting from mechanical failure of the rotating patellar component after total knee arthroplasty with the New Jersey Low-Contact-Stress (LCS) knee (DePuy, Warsaw, IN) has not been reported previously. A 67-year-old woman with rheumatoid arthritis of the left knee had a LCS prosthesis implanted without cement, using a rotating patellar component. Seven

Tetsu Watanabe; Tetsuya Tomita; Masakazu Fujii; Motoharu Kaneko; Hironobu Sakaura; Eiji Takeuchi; Kazuomi Sugamoto; Hideki Yoshikawa

2002-01-01

365

Respiratory muscle and pulmonary function in polymyositis and other proximal myopathies  

Microsoft Academic Search

We studied 53 patients with proximal myopathy to determine at what level of muscle weakness hypercapnic respiratory failure is likely, and which tests of pulmonary function or respiratory muscle strength would best suggest this development. Respiratory muscle strength was determined from maximal static efforts and in half the patients, both inspiratory and expiratory muscle strengths were less than 50% of

N M Braun; N S Arora; D F Rochester

1983-01-01

366

Failure Assessment  

Microsoft Academic Search

Failure assessment encompasses the identification and characterization both of potential failure mechanisms in systems under development and of actual failure occurrences in operational systems. This paper presents several of the most widely used and useful techniques for failure assessment across the system lifecycle with an emphasis on the role of softwar e. For each technique the paper describes its purpose

Robyn Lutz

367

Surveillance for Respiratory Syncytial Virus in Infants Hospitalized for Acute Lower Respiratory Infection in Chile (1989 to 2000)  

Microsoft Academic Search

Acute respiratory infections are a major worldwide health problem because of associated high morbidity and mortality rates. In Chile acute lower respiratory infections (ALRI) are the primary cause of hospital admissions during infancy. Re- spiratory syncytial virus (RSV) is the principal cause of ALRI, causing yearly winter epidemics that frequently challenge health resources (3, 4, 5, 9, 12, 15, 21).

Luis F. Avendano; María Angelica Palomino; Carmen Larranaga

368

Surveillance for Respiratory Syncytial Virus in Infants Hospitalized for Acute Lower Respiratory Infection in Chile (1989 to 2000)  

Microsoft Academic Search

Acute respiratory infections are a major worldwide health problem because of associated high morbidity and mortality rates. In Chile acute lower respiratory infections (ALRI) are the primary cause of hospital admissions during infancy. Re- spiratory syncytial virus (RSV) is the principal cause of ALRI, causing yearly winter epidemics that frequently challenge health resources (3, 4, 5, 9, 12, 15, 21).

Luis F. Avendano; María Angelica Palomino; Carmen Larranaga

2003-01-01

369

Respiratory syncytial virus-immunoglobulin intravenous (RSV-IGIV) for respiratory syncytial viral infections: Part I  

Microsoft Academic Search

RSV is a highly contagious, devastating disease, especially in highrisk infants. RSV infection typically presents as an upper respiratory tract infection and then may progress to the lower respiratory tract, causing pneumonia and bronchiolitis. The signs, symptoms, and severity of RSV infection vary with age and the number of previous RSV infections. Young age, premature birth, a crowded living environment,

Tracy L. Sandritter; Donna M. Kraus

1997-01-01

370

Respiratory arrest in patients undergoing arteriovenous graft placement with supraclavicular brachial plexus block: a case series.  

PubMed

Supraclavicular brachial plexus block is commonly used for upper extremity surgery. Respiratory arrest in three patients with end-stage renal disease after ultrasound-guided supraclavicular brachial plexus block for creation of an arteriovenous graft over a 6-month period is presented. Patients with renal failure may represent a group at particular risk for respiratory failure following supraclavicular brachial plexus block. PMID:23830847

Afonso, Anoushka; Beilin, Yaakov

2013-06-01

371

Advances in the management of acute liver failure  

PubMed Central

Acute liver failure (ALF) is an uncommon but dramatic clinical syndrome characterized by hepatic encephalopathy and a bleeding tendency due to abrupt loss of liver function caused by massive or submassive liver necrosis in a patient with a previously healthy liver. The causes of ALF encompass a wide variety of toxic, viral, metabolic, vascular and autoimmune insults to the liver, and identifying the correct cause can be difficult or even impossible. Many patients with ALF develop a cascade of serious complications involving almost every organ system, and death is mostly due to multi-organ failure, hemorrhage, infection, and intracranial hypertension. Fortunately, the outcome of ALF has been improved in the last 3 decades through the specific treatment for the disease of certain etiology, and the advanced intensive care management. For most severely affected patients who fail to recover after treatment, rapid evaluation for transfer to a transplantation center and consideration for liver transplantation is mandatory so that transplantation can be applied before contraindications develop. This review focuses on the recent advances in the understanding of various contributing etiologies, the administration of etiology-specific treatment to alleviate the liver injury, and the management of complications (e.g., encephalopathy, coagulopathy, cardiovascular instability, respiratory failure, renal failure, sepsis and metabolic disturbance) in patients with ALF. Assessment of the need for liver transplantation is also presented. PMID:24222950

Wang, Da-Wei; Yin, Yi-Mei; Yao, Yong-Ming

2013-01-01

372

Change in failure stress on the southern san andreas fault system caused by the 1992 magnitude = 7.4 landers earthquake.  

PubMed

The 28 June Landers earthquake brought the San Andreas fault significantly closer to failure near San Bernardino, a site that has not sustained a large shock since 1812. Stress also increased on the San Jacinto fault near San Bernardino and on the San Andreas fault southeast of Palm Springs. Unless creep or moderate earthquakes relieve these stress changes, the next great earthquake on the southern San Andreas fault is likely to be advanced by one to two decades. In contrast, stress on the San Andreas north of Los Angeles dropped, potentially delaying the next great earthquake there by 2 to 10 years. PMID:17778356

Stein, R S; King, G C; Lin, J

1992-11-20

373

Change in failure stress on the southern San Andreas fault system caused by the 1992 magnitude = 7.4 Landers earthquake  

USGS Publications Warehouse

The 28 June Landers earthquake brought the San Andreas fault significantly closer to failure near San Bernardino, a site that has not sustained a large shock since 1812. Stress also increased on the San Jacinto fault near San Bernardino and on the San Andreas fault southeast of Palm Springs. Unless creep or moderate earthquakes relieve these stress changes, the next great earthquake on the southern San Andreas fault is likely to be advanced by one to two decades. In contrast, stress on the San Andreas north of Los Angeles dropped, potentially delaying the next great earthquake there by 2 to 10 years.

Stein, R. S.; King, G. C. P.; Lin, J.

1992-01-01

374

Failure Diagnosis Using Decision Trees  

Microsoft Academic Search

We present a decision tree learning approach to diagnos- ing failures in large Internet sites. We record runtime prop- erties of each request and apply automated machine learn- ing and data mining techniques to identify the causes of failures. We train decision trees on the request traces from time periods in which user-visible failures are present. Paths through the tree

Mike Y. Chen; Alice X. Zheng; Jim Lloyd; Michael I. Jordan; Eric A. Brewer

2004-01-01

375

Boiler tube failure reduction program  

Microsoft Academic Search

Boiler tube failures are generally recognized as the major cause of forced outages of fossil power generating units for US electric utilities. In almost all cases of serious availability losses, the boiler tube failures are repeat in nature and result in multiple forced outages. Primary factors influencing repeat, rather than random, tube failures are usually found to result from not

G. A. Lamping; O. Jonas; R. J. Niebo

1991-01-01

376

The Immune Response to Viral Lower Respiratory Tract Infection  

Microsoft Academic Search

Viruses are responsible for the majority of respiratory infections in childhood,causing considerable morbidity and mortality.\\u000a It is estimated that in the United States approximately $ 652 million per year is spent on medical costs for respiratory syncytial\\u000a virus (RSV) related disease alone (Paramore et al., 2004). Viruses cause a variety of respiratory diseases in children from\\u000a the common cold to

Caroline A. Lindemans; Jan L. L. Kimpen

377

Periprosthetic fracture of the tibia associated with osteolysis caused by failure of rotating patella in low-contact-stress total knee arthroplasty.  

PubMed

Periprosthetic fracture of the tibial plateau associated with osteolysis resulting from mechanical failure of the rotating patellar component after total knee arthroplasty with the New Jersey Low-Contact-Stress (LCS) knee (DePuy, Warsaw, IN) has not been reported previously. A 67-year-old woman with rheumatoid arthritis of the left knee had a LCS prosthesis implanted without cement, using a rotating patellar component. Seven years later, a fracture of the lateral tibial plateau occurred owing to an osteolytic defect with no traumatic accident. The rotating patellar bearing over-rotated and locked; consequently, wear occurred between the patellar metal tray and the femoral component. Immunohistochemistry revealed CD68-positive macrophages in the osteolytic region and phagocytosis of metal particles. The osteolytic region was filled with autogenous bone, and all components were exchanged and cemented. The patient's condition became satisfactory with relief of pain. PMID:12478519

Watanabe, Tetsu; Tomita, Tetsuya; Fujii, Masakazu; Kaneko, Motoharu; Sakaura, Hironobu; Takeuchi, Eiji; Sugamoto, Kazuomi; Yoshikawa, Hideki

2002-12-01

378

[Failures, problems and hopes in the transformation of health services. I. Causes of erroneous decisions in the beginning phases of transformation].  

PubMed

It is generally accepted that the transformation of our health services was not a success. The reasons of failure were political and professional. Our country was too long isolated from the West and we lacked experience of countries where the reform of health services had been underway for some time. At the onset of the reform three basic findings were underrated or omitted: 1. Health needs are infinite and the resources of the health services have limits which cannot be trespassed. 2. There is no simple linear correlation between financial expenditure and the health standard. 3. The main problems of health care cannot be mastered by mere deetatization, privatization and a free market. PMID:9221178

Zácek, A

1997-02-12

379

Acute Respiratory Distress Syndrome in Lemierre's Syndrome  

PubMed Central

Lemierre's syndrome is an infectious disease defined by the presence of septic thrombophlebitis with associated embolic phenomenon, most commonly to the lungs. Here we present two cases from a single institution of acute respiratory distress syndrome (ARDS) developing as a result of Lemierre's syndrome in previously healthy young adult men. ARDS can occur as a consequence of pulmonary septic emboli and sepsis, both of which are well-described consequences of Lemierre's syndrome. We describe important diagnostic and management considerations in the care of patients with hypoxemic respiratory failure and Lemierre's syndrome. Essential components of management include prompt antibiotic therapy, lung-protective ventilation strategies, and supportive care. PMID:25143837

Hein, Paul N.; Soghikian, Maida V.; Bhangoo, Munveer S.

2014-01-01

380

Early infantile sensory-motor neuropathy with late onset respiratory distress.  

PubMed

Children with spinal muscular atrophy with respiratory distress (SMARD1) usually present within their first year of life, with respiratory failure due to diaphragmatic paralysis and progressive distal limb weakness. We present a child with a confirmed compound heterozygous IGHMBP2 mutation c.[676G>T];[2083A>T] in whom severe sensory-motor neuropathy preceded diaphragmatic paralysis by almost 3years. Autonomic system involvement with neurogenic bladder and urine retention were found at 3years. In summary, our patient highlights the broad spectrum of phenotypes observed in SMARD1. Currently, no prediction of phenotype according to genotype is possible, suggesting that yet unknown factors cause the observed phenotypic variation. Even in the absence of obvious diaphragmatic weakness, SMARD1 should be considered in severe infantile onset neuropathies. High throughput techniques, such as next generation sequencing, will possibly offer a useful approach in the heterogeneous group of inherited neuropathies. PMID:24342282

Blaschek, Astrid; Gläser, Dieter; Kuhn, Marius; Schroeder, Andreas Sebastian; Wimmer, Cornelius; Heimkes, Bernd; Schön, Carola; Müller-Felber, Wolfgang

2014-03-01

381

METHODS USED TO STUDY RESPIRATORY VIRUS INFECTION  

PubMed Central

This unit describes protocols for infecting the mouse respiratory tract, and assaying virus replication and host response in the lung. Respiratory infections are the leading cause of acute illness worldwide, affecting mostly infants and children in developing countries. The purpose of this unit is to provide the readers with a basic strategy and protocols to study the pathogenesis and immunology of respiratory virus infection using the mouse as an animal model. The procedures include: (i) basic techniques for mouse infection, tissue sampling and preservation, (ii) determination of viral titers, isolation and analysis of lymphocytes and dendritic cells using flow-cytometry, and (iii) lung histology, immunohistochemistry and in situ hybridization. PMID:19499505

Flano, Emilio; Jewell, Nancy A.; Durbin, Russell K.; Durbin, Joan E.

2009-01-01

382

Health Care-Acquired Viral Respiratory Diseases  

PubMed Central

Health care–associated viral respiratory infections, common among hospitalized children, also occur among adults and institutionalized persons and result in increased patient morbidity, mortality, and health care costs. Approximately 20% of patients with health care–associated pneumonia have viral respiratory infections, with 70% of these infections caused by adenovirus, influenza virus, parainfluenza virus, and respiratory syncytial virus (RSV).1 These infections typically reflect the level of viral activity within the community.1,2 This article focuses on the epidemiology, transmission, and control of health care–associated RSV and influenza virus. PMID:21316002

Goins, William P.; Talbot, H. Keipp; Talbot, Thomas R.

2014-01-01

383

Mechanical Properties of Respiratory Muscles  

PubMed Central

Striated respiratory muscles are necessary for lung ventilation and to maintain the patency of the upper airway. The basic structural and functional properties of respiratory muscles are similar to those of other striated muscles (both skeletal and cardiac). The sarcomere is the fundamental organizational unit of striated muscles and sarcomeric proteins underlie the passive and active mechanical properties of muscle fibers. In this respect, the functional categorization of different fiber types provides a conceptual framework to understand the physiological properties of respiratory muscles. Within the sarcomere, the interaction between the thick and thin filaments at the level of cross-bridges provides the elementary unit of force generation and contraction. Key to an understanding of the unique functional differences across muscle fiber types are differences in cross-bridge recruitment and cycling that relate to the expression of different myosin heavy chain isoforms in the thick filament. The active mechanical properties of muscle fibers are characterized by the relationship between myoplasmic Ca2+ and cross-bridge recruitment, force generation and sarcomere length (also cross-bridge recruitment), external load and shortening velocity (cross-bridge cycling rate), and cross-bridge cycling rate and ATP consumption. Passive mechanical properties are also important reflecting viscoelastic elements within sarcomeres as well as the extracellular matrix. Conditions that affect respiratory muscle performance may have a range of underlying pathophysiological causes, but their manifestations will depend on their impact on these basic elemental structures. PMID:24265238

Sieck, Gary C.; Ferreira, Leonardo F.; Reid, Michael B.; Mantilla, Carlos B.

2014-01-01

384

While soil-applied herbicides can be quite valuable in weed control, misuse can cause crop injury or failure to control weeds. This guide  

E-print Network

While soil-applied herbicides can be quite valuable in weed control, misuse can cause crop injury and persistence of soil-applied herbicides. MT200405 AG issued 5/04 D-4 Getting the Most from Soil-Applied Herbicides by Fabián D. Menalled, Extension Cropland Weeds Specialist, and William E. Dyer, Professor, Weed

Maxwell, Bruce D.

385

Acute liver failure caused by herpes simplex virus in a pregnant patient: is there a potential role for therapeutic plasma exchange?  

PubMed

A young woman presented with a febrile illness in the third trimester of pregnancy. Laboratory investigation revealed severe acute hepatitis with thrombocytopenia and coagulopathy. Liver injury progressed despite emergent caesarian section and delivery of a healthy infant. Therefore, therapeutic plasma exchange (TPE) was performed on three consecutive days post-partum for a presumed diagnosis of acute liver failure (ALF) associated with pregnancy due to hemolysis, elevated liver enzymes, and low platelets (HELLP) or acute fatty liver of pregnancy (AFLP). Treatment with TPE was followed by biochemical and clinical improvement but during her recovery herpes simplex virus type 2 (HSV-2) infection was diagnosed serologically and confirmed histologically. Changes in the immune system during pregnancy make pregnant patients more susceptible to acute HSV hepatitis, HSV-related ALF, and death. The disease is characterized by massive hepatic inflammation with hepatocyte necrosis, mediated by both direct viral cytotoxicity and the innate humoral immune response. TPE may have a therapeutic role in acute inflammatory disorders such as HSV hepatitis by reducing viral load and attenuating systemic inflammation and liver cell injury. Further investigation is needed to clarify this potential effect. The roles of vigilance, clinical suspicion, and currently accepted therapies are emphasized. PMID:23857723

Holt, Edward W; Guy, Jennifer; Gordon, Shelley M; Hofmann, Jan C; Garcia-Kennedy, Richard; Steady, Stephen L; Bzowej, Natalie H; Frederick, R Todd

2013-12-01

386

Preliminary results: Root cause investigation of orbital anomalies and failures in NASA standard 50 ampere-hour nickel-cadmium batteries  

NASA Technical Reports Server (NTRS)

Two lots of NASA standard 50 A.H. Ni-Cd battery cells, manufactured by Gates Aerospace Batteries and built into batteries by McDonnell Douglas, have experienced significant performance problems. The two lots were used on the Compton Gamma Ray Observatory and the Upper Atmosphere Research Satellite. Both of these satellites are Low Earth Orbital (LEO) satellites containing batteries on a parallel bus charged to NASA standard V/T curves using a NASA standard power regulator. The following preliminary conclusions were reached: (1) several plate and cell parameters have migrated within their spec limits over the years (in some cases, from one extreme to the other); (2) several parametric relationships, not generally monitored and therefore not under specification control, have also migrated over the years; (3) many of these changes appear to have taken place as a natural consequence of changes in GE/GAB materials and processes; (4) several of these factors may be 'conspiring' to aggravate known cell failure mechanisms (factors such as heavier plate, less teflon and/or less-uniform teflon, and less electrolyte) but all are still in spec (where specs exist); (5) the weight of the evidence collected to characterize the anomalies and to characterize the negative electrode itself, strongly suggests that alterations to the structure, composition, uniformity, and efficiency of the negative electrode are at the heart of the battery performance problems currently being experienced; and (6) further investigation at all levels (plate, cell, battery, and system) continues to be warranted.

Toft, Mark R.

1993-01-01

387

Endoscopy: a must in neonatal respiratory distress  

Microsoft Academic Search

Respiratory distress in a newborn presents both diagnostic and therapeutic dilemmas. Definitive treatment must be preceded by an accurate diagnosis other than in extremes. Complete tracheal rings are a very rare congenital cause of airway obstruction. Unlike other causes of upper airway obstruction, this cannot be relieved by tracheostomy, which may be counterproductive. We report the case of an 8-day-old

M. K. Aneeshkumar; E. Osman; S. Ghosh; R. W. Clarke

2005-01-01

388

Sustained Oxidative Stress Causes Late Acute Renal Failure via Duplex Regulation on p38 MAPK and Akt Phosphorylation in Severely Burned Rats  

PubMed Central

Background Clinical evidence indicates that late acute renal failure (ARF) predicts high mortality in severely burned patients but the pathophysiology of late ARF remains undefined. This study was designed to test the hypothesis that sustained reactive oxygen species (ROS) induced late ARF in a severely burned rat model and to investigate the signaling mechanisms involved. Materials and Methods Rats were exposed to 100°C bath for 15 s to induce severe burn injury (40% of total body surface area). Renal function, ROS generation, tubular necrosis and apoptosis, and phosphorylation of MAPK and Akt were measured during 72 hours after burn. Results Renal function as assessed by serum creatinine and blood urea nitrogen deteriorated significantly at 3 h after burn, alleviated at 6 h but worsened at 48 h and 72 h, indicating a late ARF was induced. Apoptotic cells and cleavage caspase-3 in the kidney went up slowly and turned into significant at 48 h and 72 h. Tubular cell ROS production shot up at 6 h and continuously rose during the 72-h experiment. Scavenging ROS with tempol markedly attenuated tubular apoptosis and renal dysfunction at 72 h after burn. Interestingly, renal p38 MAPK phosphorylation elevated in a time dependent manner whereas Akt phosphorylation increased during the first 24 h but decreased at 48 h after burn. The p38 MAPK specific inhibitor SB203580 alleviated whereas Akt inhibitor exacerbated burn-induced tubular apoptosis and renal dysfunction. Furthermore, tempol treatment exerted a duplex regulation through inhibiting p38 MAPK phosphorylation but further increasing Akt phosphorylation at 72 h postburn. Conclusions These results demonstrate that sustained renal ROS overproduction induces continuous tubular cell apoptosis and thus a late ARF at 72 h after burn in severely burned rats, which may result from ROS-mediated activation of p38 MAPK but a late inhibition of Akt phosphorylation. PMID:23349934

Cai, Xiaoqing; Wang, Dexin; Wu, Kaimin; Chen, Hongli; Li, Jia; Lei, Wei

2013-01-01

389

A3 adenosine receptor antagonists delay irreversible synaptic failure caused by oxygen and glucose deprivation in the rat CA1 hippocampus in vitro  

PubMed Central

The role of adenosine A3 receptor activation during ischaemia-like conditions produced by oxygen and glucose deprivation (OGD) was evaluated with extracellular recordings from the CA1 region of rat hippocampal slices. In all, 7?min of OGD evoked tissue anoxic depolarisation (AD, peak at ?7?min from OGD start, n=20) and were invariably followed by irreversible loss of electrically evoked field epsps (fepsps, n=42). The selective adenosine A3 antagonists 3-propyl-6-ethyl-5[(ethylthio)carbonyl]-2-phenyl-4-propyl-3-pyridinecarboxylate (MRS 1523, 1–100?nM, n=31), N-[9-chloro-2-(2-furanyl)[1,2,4]-triazolo[1,5-c]quinazolin-5-yl]benzeneacetamide (MRS 1220, 100?nM, n=7), N-(2-methoxyphenyl)-N?-[2-(3-pyrindinyl)-4-quinazolinyl]-urea, (VUF 5574, 100?nM, n=3) and 5-[[(4-pyridyl)amino]carbonyl]amino-8-methyl-2-(2-furyl)-pyrazolo[4,3-e]1,2,4-triazolo[1,5-c]pyrimidine hydrochloride (1?nM, n=4), prevented the irreversible failure of neurotransmission induced by 7?min OGD (n=45) and the development of AD in 20 out of 22 monitored slices. When tested on OGD episodes of longer duration (8–10?min, n=18), 100?nM MRS 1523 prevented or delayed the appearance of AD and exerted a protective effect on neurotransmission for episodes of up to 9?min duration. In the absence of AD, the fepsp recovery was almost total, regardless of OGD episode duration. These findings support the notion that A3 receptor stimulation is deleterious during ischaemia and suggest that selective A3 receptor block may substantially increase the resistance of the CA1 hippocampal region to ischaemic damage. PMID:16415905

Pugliese, Anna Maria; Coppi, Elisabetta; Spalluto, Giampiero; Corradetti, Renato; Pedata, Felicita

2006-01-01

390

Airway Reflux, Cough and Respiratory Disease  

PubMed Central

It is increasingly accepted that the effects of gastro-oesophageal reflux are not limited to the gastrointestinal tract. The adjacent respiratory structures are also at risk from material ejected from the proximal oesophagus as a result of the failure of anatomical and physiological barriers. There is evidence of the influence of reflux on several respiratory and otorhinological conditions and although in many cases the precise mechanism has yet to be elucidated, the association alone opens potential novel avenues of therapy to clinicians struggling to treat patients with apparently intractable respiratory complaints. This review provides a description of the airway reflux syndrome, its effects on the lung and current and future therapeutic options. PMID:23251752

Molyneux, Ian D.; Morice, Alyn H.

2011-01-01

391

Equipment Failure Analysis  

NASA Technical Reports Server (NTRS)

Tennessee Eastman uses NASTRAN to minimize lost production by pinpointing the causes of equipment failures and preventing recurrences. An example of the program's utility involves a large centrifugal fan which developed cracks during start-ups and shutdowns. This information prompted redesign of the fan. Tennessee Eastman has made extensive use of NASTRAN, both as failure analysis tool and as an aid in redesigning production hardware.

1980-01-01

392

The human respiratory gate  

NASA Technical Reports Server (NTRS)

Respiratory activity phasically alters membrane potentials of preganglionic vagal and sympathetic motoneurones and continuously modulates their responsiveness to stimulatory inputs. The most obvious manifestation of this 'respiratory gating' is respiratory sinus arrhythmia, the rhythmic fluctuations of electrocardiographic R-R intervals observed in healthy resting humans. Phasic autonomic motoneurone firing, reflecting the throughput of the system, depends importantly on the intensity of stimulatory inputs, such that when levels of stimulation are low (as with high arterial pressure and sympathetic activity, or low arterial pressure and vagal activity), respiratory fluctuations of sympathetic or vagal firing are also low. The respiratory gate has a finite capacity, and high levels of stimulation override the ability of respiration to gate autonomic responsiveness. Autonomic throughput also depends importantly on other factors, including especially, the frequency of breathing, the rate at which the gate opens and closes. Respiratory sinus arrhythmia is small at rapid, and large at slow breathing rates. The strong correlation between systolic pressure and R-R intervals at respiratory frequencies reflects the influence of respiration on these two measures, rather than arterial baroreflex physiology. A wide range of evidence suggests that respiratory activity gates the timing of autonomic motoneurone firing, but does not influence its tonic level. I propose that the most enduring significance of respiratory gating is its use as a precisely controlled experimental tool to tease out and better understand otherwise inaccessible human autonomic neurophysiological mechanisms.

Eckberg, Dwain L.

2003-01-01

393

Dose-dependent Na and Ca in fluoride-rich drinking water--another major cause of chronic renal failure in tropical arid regions.  

PubMed

Endemic occurrence of chronic kidney disease with unknown etiology is reported in certain parts of the north central dry zone of Sri Lanka and has become a new and emerging health issue. The disease exclusively occurs in settlements where groundwater is the main source of drinking water and is more common among low socio-economic groups, particularly among the farming community. Due to its remarkable geographic distribution and histopathological evidence, the disease is believed to be an environmentally induced problem. This paper describes a detailed hydrogeochemical study that has been carried out covering endemic and non-endemic regions. Higher fluoride levels are common in drinking water from both affected and non-affected regions, whereas Ca-bicarbonate type water is more common in the affected regions. In terms of the geochemical composition of drinking water, affected households were rather similar to control regions, but there is a large variation in the Na/Ca ratio within each of the two groups. Fluoride as shown in this study causes renal tubular damage. However it does not act alone and in certain instances it is even cytoprotective. The fine dividing line between cytotoxicity and cytoprotectivity of fluoride appears to be the effect of Ca(2+) and Na(+) of the ingested water on the F(-) metabolism. This study illustrates a third major cause (the other two being hypertension and diabetes) of chronic kidney diseases notably in tropical arid regions such as the dry zone of Sri Lanka. PMID:21109289

Chandrajith, Rohana; Dissanayake, C B; Ariyarathna, Thivanka; Herath, H M J M K; Padmasiri, J P

2011-01-15

394

Synthetic cannabis and respiratory depression.  

PubMed

In recent years, synthetic cannabis use has been increasing in appeal among adolescents, and its use is now at a 30 year peak among high school seniors. The constituents of synthetic cannabis are difficult to monitor, given the drug's easy accessibility. Currently, 40 U.S. states have banned the distribution and use of some known synthetic cannabinoids, and have included these drugs in the Schedule I category. The depressive respiratory effect in humans caused by synthetic cannabis inhalation has not been thoroughly investigated in the medical literature. We are the first to report, to our knowledge, two cases of self-reported synthetic cannabis use leading to respiratory depression and necessary intubation. PMID:23234589

Jinwala, Felecia N; Gupta, Mayank

2012-12-01

395

Respiratory syncytial virus vaccine development  

PubMed Central

Respiratory syncytial virus (RSV) is the leading cause of lower respiratory tract viral disease in infants and young children. Presently, there are no explicit recommendations for RSV treatment apart from supportive care. The virus is therefore responsible for an estimated 160,000 deaths per year worldwide. Despite half a century of dedicated research, there remains no licensed vaccine product. Herein are described past and current efforts to harness innate and adaptive immune potentials to combat RSV. A plethora of candidate vaccine products and strategies are reviewed. The development of a successful RSV vaccine may ultimately stem from attention to historical lessons, in concert with an integral partnering of immunology and virology research fields. PMID:21988307

Hurwitz, Julia L

2011-01-01

396

Fourth European Conference on Infections in Leukaemia (ECIL-4): Guidelines for Diagnosis and Treatment of Human Respiratory Syncytial Virus, Parainfluenza Virus, Metapneumovirus, Rhinovirus, and Coronavirus  

PubMed Central

Community-acquired respiratory virus (CARV) infections have been recognized as a significant cause of morbidity and mortality in patients with leukemia and those undergoing hematopoietic stem cell transplantation (HSCT). Progression to lower respiratory tract infection with clinical and radiological signs of pneumonia and respiratory failure appears to depend on the intrinsic virulence of the specific CARV as well as factors specific to the patient, the underlying disease, and its treatment. To better define the current state of knowledge of CARVs in leukemia and HSCT patients, and to improve CARV diagnosis and management, a working group of the Fourth European Conference on Infections in Leukaemia (ECIL-4) 2011 reviewed the literature on CARVs, graded the available quality of evidence, and made recommendations according to the Infectious Diseases Society of America grading system. Owing to differences in screening, clinical presentation, and therapy for influenza and adenovirus, ECIL-4 recommendations are summarized for CARVs other than influenza and adenovirus. PMID:23024295

Hirsch, Hans H.; Martino, Rodrigo; Ward, Katherine N.; Boeckh, Michael; Einsele, Hermann; Ljungman, Per

2013-01-01

397

[Circulatory failures].  

PubMed

To treat circulatory failures and recognize their mechanisms, we need to understand circulatory physiology. What determines systemic venous return? How does the right ventricle feed the pulmonary circulation? Where is the left ventricular preload reserve located? Four types of circulatory failure are conventionally recognized: hypovolemic, obstructive, vasoplegic and cardiogenic. One or more of these mechanisms may account for circulatory failure in septic shock. Treatment of circulatory failure requires admission to a specialized unit and continuous or discontinuous hemodynamic monitoring. Prognosis is highly dependent on rapid treatment and correction of circulatory impairment. PMID:16764243

Charron, Cyril; Belliard, Guillaume; Vieillard-Baron, Antoine

2006-04-30

398

[Poisoning caused by the organophosphate parathion (E-605)].  

PubMed

In a 41-year-old patient administration of 5 g parathion led to respiratory failure and unconsciousness. Ventilatory support and antidote therapy were initiated early. However, only extensive gastric lavage and lowering of the plasma concentration by hemoperfusion with activated carbon resulted in the crucial elimination of the poison. Antidote and supportive measures may overcome the hazards of cholinesterase-inhibition, but not the direct toxic effect on the cardiovascular system which is currently regarded as the predominant cause of death. PMID:6879138

Windler, E; Dreyer, M; Runge, M

1983-06-11

399

Respiratory Care Therapist.  

ERIC Educational Resources Information Center

This document, which is designed for use in developing a tech prep competency profile for the occupation of respiratory care therapist, lists technical competencies and competency builders for 18 units pertinent to the health technologies cluster in general as well as those specific to the occupation of respiratory care therapist. The following…

Ohio State Univ., Columbus. Center on Education and Training for Employment.

400

Occupational respiratory diseases in the South African mining industry  

PubMed Central

Background Crystalline silica and asbestos are common minerals that occur throughout South Africa, exposure to either causes respiratory disease. Most studies on silicosis in South Africa have been cross-sectional and long-term trends have not been reported. Although much research has been conducted on the health effects of silica dust and asbestos fibre in the gold-mining and asbestos-mining sectors, little is known about their health effects in other mining sectors. Objective The aims of this thesis were to describe silicosis trends in gold miners over three decades, and to explore the potential for diamond mine workers to develop asbestos-related diseases and platinum mine workers to develop silicosis. Methods Mine workers for the three sub-studies were identified from a mine worker autopsy database at the National Institute for Occupational Health. Results From 1975 to 2007, the proportions of white and black gold mine workers with silicosis increased from 18 to 22% and from 3 to 32% respectively. Cases of diamond and platinum mine workers with asbestos-related diseases and silicosis, respectively, were also identified. Conclusion The trends in silicosis in gold miners at autopsy clearly demonstrate the failure of the gold mines to adequately control dust and prevent occupational respiratory disease. The two case series of diamond and platinum mine workers contribute to the evidence for the risk of asbestos-related diseases in diamond mine workers and silicosis in platinum mine workers, respectively. The absence of reliable environmental dust measurements and incomplete work history records impedes occupational health research in South Africa because it is difficult to identify and/or validate sources of dust exposure that may be associated with occupational respiratory disease. PMID:23364097

Nelson, Gill

2013-01-01

401

Heart Failure  

MedlinePLUS

... failure" simply means that your heart isn't pumping blood as well as it should. Heart failure does not mean ... your heart. The pictures show your doctor how well your heart is pumping. Radionuclide ventriculography involves injecting a very small amount ...

402

Productive Failure  

ERIC Educational Resources Information Center

This study demonstrates an existence proof for "productive failure": engaging students in solving complex, ill-structured problems without the provision of support structures can be a productive exercise in failure. In a computer-supported collaborative learning setting, eleventh-grade science students were randomly assigned to one of two…

Kapur, Manu

2008-01-01

403

Primary defect of congenital dyserythropoietic anemia type II. Failure in glycosylation of erythrocyte lactosaminoglycan proteins caused by lowered N-acetylglucosaminyltransferase II.  

PubMed

Congenital dyserythropoietic anemia type II or hereditary erythroblastic multinuclearity with positive acidified serum test (HEMPAS) is a genetic disease caused by membrane abnormality. Previously we have found that Band 3 and Band 4.5 are not glycosylated by lactosaminoglycans in HEMPAS erythrocytes, whereas normally these proteins have lactosaminoglycans (Fukuda, M. N., Papayannopoulou, T., Gordon-Smith, E. C., Rochant, H., and Testa, U. (1984) Br. J. Haematol. 56, 55-68). In order to find out where glycosylation of lactosaminoglycans stops, we have analyzed the carbohydrate structures of HEMPAS Band 3. By fast atom bombardment-mass spectrometry, methylation analysis, and hydrazinolysis followed by exoglycosidase treatments, the following structure was elucidated: (formula; see text) N-Linked glycopeptides synthesized in vitro by reticulocyte microsomes from HEMPAS were shown to be predominantly the above short oligosaccharide, whereas those from normal reticulocytes contain large molecular weight carbohydrates. The N-acetylglucosaminyltransferase II, which transfers N-acetylglucosamine to the C-2 position of the Man alpha 1----6Man beta 1----arm of the biantennary core structure, was therefore examined by using Man alpha 1----6(GlcNAc beta 1----2Man alpha 1----3)Man beta 1----4GlcNAc beta 1----4GlcNAcol as an acceptor. N-Acetylglucosaminyltransferase II activity was demonstrated in the lymphocyte microsome fraction from normal individuals. However, this enzyme activity was found to be decreased in those from HEMPAS patients. These results suggest that the primary defect of HEMPAS lies in the lowered activity of N-acetylglucosaminyltransferase II. PMID:2953718

Fukuda, M N; Dell, A; Scartezzini, P

1987-05-25

404

[Cheyne-Stokes respiration in patients with congestive heart failure].  

PubMed

Cheyne-Stokes respiration (CSR) during sleep is common in patients with severe congestive heart failure induces repetitive oxygen desaturation with arousals, and impairs sleep. This causes daytime symptoms and likely an increase in sympathetic activity. It has, therefore, been suggested that CSR is independently related to mortality. The major mechanisms behind CSR include reduced body stores of oxygen, a low apneic threshold for carbon dioxide, prolonged circulation time between the lung and the carotid body, and disturbance of respiratory control due to arousals. It is apparent that the main task in treating CSR is the therapy of congestive heart failure. Indeed, diuretics to treat pulmonary congestion as well as ACE-inhibitors reduce CSR. Recently, theophylline (an antagonist of the ventilatory depressant adenosine) was shown to reduce CSR and oxygen-desaturation. Continuous positive airway pressure did improve CSR but not sleep and may reduce cardiac output in a subgroup of patients with heart failure. Nocturnal oxygen reduces CSR and improves exercise tolerance as well as sleep. This and its apparent safety makes oxygen an appropriate treatment for nocturnal CSR. Whether successful treatment of nocturnal CSR has any impact on the natural course of heart failure needs to be determined in further studies. PMID:9531695

Andreas, S; Kreuzer, H

1998-01-01

405

Evaluation of quantitative and type-specific real-time RT-PCR assays for detection of respiratory syncytial virus in respiratory specimens from children  

Microsoft Academic Search

Background: Respiratory syncytial virus (RSV) is a major cause of lower respiratory tract morbidity in young children and immunosuppressed patients. Objectives: To rapidly and accurately quantify and subtype RSV in respiratory samples, we developed and evaluated two real-time RT-PCR assays. Study design: A quantitative assay was designed using primers for a consensus region of the matrix protein gene and a

Jane Kuypers; Nancy Wright; Rhoda Morrow

2004-01-01

406

Effects of Nasal or Pulmonary Delivered Treatments with an Adenovirus Vectored Interferon (mDEF201) on Respiratory and Systemic Infections in Mice Caused by Cowpox and Vaccinia Viruses  

PubMed Central

An adenovirus 5 vector encoding for mouse interferon alpha, subtype 5 (mDEF201) was evaluated for efficacy against lethal cowpox (Brighton strain) and vaccinia (WR strain) virus respiratory and systemic infections in mice. Two routes of mDEF201 administration were used, nasal sinus (5-µl) and pulmonary (50-µl), to compare differences in efficacy, since the preferred treatment of humans would be in a relatively small volume delivered intranasally. Lower respiratory infections (LRI), upper respiratory infections (URI), and systemic infections were induced by 50-µl intranasal, 10-µl intranasal, and 100-µl intraperitoneal virus challenges, respectively. mDEF201 treatments were given prophylactically either 24 h (short term) or 56d (long-term) prior to virus challenge. Single nasal sinus treatments of 106 and 107 PFU/mouse of mDEF201 protected all mice from vaccinia-induced LRI mortality (comparable to published studies with pulmonary delivered mDEF201). Systemic vaccinia infections responded significantly better to nasal sinus delivered mDEF201 than to pulmonary treatments. Cowpox LRI infections responded to 107 mDEF201 treatments, but a 106 dose was only weakly protective. Cowpox URI infections were equally treatable by nasal sinus and pulmonary delivered mDEF201 at 107 PFU/mouse. Dose-responsive prophylaxis with mDEF201, given one time only 56 d prior to initiating a vaccinia virus LRI infection, was 100% protective from 105 to 107 PFU/mouse. Improvements in lung hemorrhage score and lung weight were evident, as were decreases in liver, lung, and spleen virus titers. Thus, mDEF201 was able to treat different vaccinia and cowpox virus infections using both nasal sinus and pulmonary treatment regimens, supporting its development for humans. PMID:23874722

Smee, Donald F.; Wong, Min-Hui; Hurst, Brett L.; Ennis, Jane; Turner, Jeffrey D.

2013-01-01

407

Identification of a protein mediating respiratory supercomplex stability  

PubMed Central

The complexes of the electron transport chain associate into large macromolecular assemblies, which are believed to facilitate efficient electron flow. We have identified a conserved mitochondrial protein, named Respiratory superComplex Factor 1 (Rcf1—Yml030w), that is required for the normal assembly of respiratory supercomplexes. We demonstrate that Rcf1 stably and independently associates with both Complex III and Complex IV of the electron transport chain. Deletion of the RCF1 gene caused impaired respiration, probably as a result of destabilization of respiratory supercomplexes. Consistent with the hypothetical function of these respiratory assemblies, loss of RCF1 caused elevated mitochondrial oxidative stress and damage. Finally, we show that knockdown of HIG2A, a mammalian homolog of RCF1, causes impaired supercomplex formation. We suggest that Rcf1 is a member of an evolutionarily conserved protein family that acts to promote respiratory supercomplex assembly and activity. PMID:22405070

Chen, Yu-Chan; Taylor, Eric B.; Dephoure, Noah; Heo, Jin-Mi; Tonhato, Aline; Papandreou, Ioanna; Nath, Nandita; Denko, Nicolas C.; Gygi, Steven P.; Rutter, Jared

2012-01-01

408

Early Noninvasive Ventilation Averts Extubation Failure in Patients at Risk A Randomized Trial  

Microsoft Academic Search

Rationale: Respiratory failure after extubation and reintubation is associated with increased morbidity and mortality. Objectives: To assess the efficacy of noninvasive ventilation in avert- ing respiratory failure after extubation in patients at increased risk. Methods: A prospective randomized controlled trial was conducted in 162 mechanically ventilated patients who tolerated a spontane- ous breathing trial after recovery from the acute episode

Miquel Ferrer; Mauricio Valencia; Josep Maria Nicolas; Oscar Bernadich; Joan Ramon Badia; Antoni Torres

409

Respiratory viruses in children hospitalized for acute lower respiratory tract infection in Ghana  

PubMed Central

Background Acute respiratory tract infections are one of the major causes of morbidity and mortality among young children in developing countries. Information on the viral aetiology of acute respiratory infections in developing countries is very limited. The study was done to identify viruses associated with acute lower respiratory tract infection among children less than 5 years. Method Nasopharyngeal samples and blood cultures were collected from children less than 5 years who have been hospitalized for acute lower respiratory tract infection. Viruses and bacteria were identified using Reverse Transcriptase Real-Time Polymerase Chain Reaction and conventional biochemical techniques. Results Out of 128 patients recruited, 33(25.88%%, 95%CI: 18.5% to 34.2%) were positive for one or more viruses. Respiratory Syncytial Virus (RSV) was detected in 18(14.1%, 95%CI: 8.5% to 21.3%) patients followed by Adenoviruses (AdV) in 13(10.2%, 95%CI: 5.5% to 16.7%), Parainfluenza (PIV type: 1, 2, 3) in 4(3.1%, 95%CI: 0.9% to 7.8%) and influenza B viruses in 1(0.8%, 95%CI: 0.0 to 4.3). Concomitant viral and bacterial co-infection occurred in two patients. There were no detectable significant differences in the clinical signs, symptoms and severity for the various pathogens isolated. A total of 61.1% (22/36) of positive viruses were detected during the rainy season and Respiratory Syncytial Virus was the most predominant. Conclusion The study has demonstrated an important burden of respiratory viruses as major causes of childhood acute respiratory infection in a tertiary health institution in Ghana. The data addresses a need for more studies on viral associated respiratory tract infection. PMID:22490115

2012-01-01

410

Climate change and respiratory disease: European Respiratory Society position statement  

Microsoft Academic Search

Climate change will affect individuals with pre-existing respiratory disease, but the extent of the effect remains unclear. The present position statement was developed on behalf of the European Respiratory Society in order to identify areas of concern arising from climate change for individuals with respiratory disease, healthcare workers in the respiratory sector and policy makers. The statement was developed following

J. G. Ayres; B. Forsberg; I. Annesi-Maesano; R. Dey; K. L. Ebi; P. J. Helms; M. Medina-Ramon; M. Windt; F. Forastiere

2009-01-01

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How Can I Live with Heart Failure?  

MedlinePLUS

What medicine might I take? The goal of heart failure treatment is to help you live a longer, better-quality life. Treating the causes of heart failure with medication can lessen tiredness (fatigue), shortness of ...

412

Exposure to organic dust and respiratory disorders  

Microsoft Academic Search

Chapter 1 summarises the background of the study. Nonmalignant respiratory disorders account for a significant part of sick leave diagnoses (19%), disability pension (3.4%) and mortality (7%). The rate of chronic obstructive pulmonary diseases has risen substantially during the last 10 to 20 years. Allthough smoking is a major external cause for the increasing mortality and morbidity, other environmental factors

T. Smid