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Effects of diabetic ketoacidosis in the respiratory system

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World Journal of Diabetes 2019年第1期10卷 16-22页

作者： Alice Gallo de Moraes Salim Surani Department of medicine Division of Pulmonary and Critical Care Medicine division of pulmonary Critical Care and Sleep Medicine Texas A and M University

Diabetes affects approximately 30 million persons in the United States. Diabetes ketoacidosis is one of the most serious and acute complications of diabetes. At the time of presentation and during treatment of diabetic ketoacidosis(DKA), several metabolic and electrolyte derangements can ultimately result in respiratory compromise. Most commonly, hypokalemia, hypomagnesemia and hypophosphatemia can eventually lead to respiratory muscles ***, tachypnea, hyperpnea and more severely, Kussmaul breathing pattern can develop. Also, hydrostatic and non-hydrostatic pulmonary edema can occur secondary to volume shifts into the extracellular space and secondary to increased permeability of the pulmonary capillaries. The presence of respiratory failure in patients with DKA is associated with higher morbidity and mortality. Being familiar with the causes of respiratory compromise in DKA, and how to treat them, may represent better outcomes for patients with DKA.

关键词： Diabetes ketoacidosis Respiratory physiology Mechanical ventilation metabolic acidosis Hyperventilation Kussmaul breathing Respiratory failure

Retropharyngeal abscess presenting as acute airway obstruction in a 66-year-old woman: A case report

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World Journal of Clinical Cases 2019年第22期7卷 3838-3843页

作者： Jian Lin Xiao-Mai Wu Jia-Xi Feng Mei-Fang Chen division of pulmonary and critical care medicine Wenzhou Medical University Affiliated Taizhou Hospital

BACKGROUND Adult retropharyngeal abscess(RPA)is extremely rare,and most cases reported in the literature were related to tuberculous *** present a case of RPA with acute airway obstruction as the main manifestation in a 66-year-old woman that was considered to be non-tubercular suppurative inflammation in the retropharyngeal *** SUMMARY A 66-year-old woman complaining of chills and fever was admitted to our *** was initially diagnosed with an acute upper respiratory tract *** lost consciousness twice during *** regained consciousness immediately upon emergency tracheal *** upper airway obstruction was suspected as arterial blood gas analysis showed obvious acute retention of carbon dioxide before the second tracheal *** diagnosis of RPA was confirmed by computed tomography and magnetic resonance *** kristinae was isolated from blood samples taken from both *** patient recovered and was subsequently discharged after receiving antibiotic therapy together with surgical incision and drainage of the *** Clinicians should be alert to the possibility of RPA in patients with acute airway *** incision and drainage is an effective treatment for RPA.

关键词： Retropharyngeal abscess Airway obstruction Kocuria kristinae Intubation Surgery Case report

Boarding issue in a commercial flight for patients with cavitary pulmonary tuberculosis: A case report

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World Journal of Clinical Cases 2020年第3期8卷 546-551页

作者： Woori Jo Chuiyong Pak Yangjin Jegal Kwang Won Seo division of pulmonary and critical care medicine Department of Internal Medicine Ulsan University Hospital University of Ulsan College of Medicine

BACKGROUND Several studies have demonstrated that airborne transmission of Mycobacterium tuberculosis bacteria from patients with active pulmonary tuberculosis(TB) to other passengers or crew members can occur during long flights. As such, non-infectious TB patients are usually allowed to undertake air travel after taking the appropriate anti-TB drugs. However, the global guidelines for air travel for patients with TB are inconsistent and insufficiently detailed with respect to cavitary pulmonary TB(CPTB).CASE SUMMARY Here, we report a case in which a patient with multiple CPTB was permitted air travel, following negative sputum acid-fast bacilli smear tests after administration of proper anti-TB medication. The patient’s culture results were *** This case revealed that more specific guidelines regulating air travel for patients with CPTB are necessary.

关键词： pulmonary tuberculosis Air travel Mycobacterium Case report

Current role of extracorporeal membrane oxygenation for the management of trauma patients:Indications and results

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World Journal of critical care medicine 2025年第1期14卷 42-48页

作者： Mohammed Abdulrahman Maryam Makki Malak Bentaleb Dana Khamis Altamimi Marcelo AF Ribeiro Junior Department of Surgery College of Medicine and Health SciencesKhalifa UniversityAbu Dhabi 11001United Arab Emirates Department of Surgery Division of TraumaCritical Care and Acute Care SurgerySheikh Shakhbout Medical CityAbu Dhabi 11001United Arab Emirates Department of Surgery Sheikh Shakhbout Medical CityAbu Dhabi 91888ADUnited Arab Emirates Department of Surgery R Adams Cowley Shock Trauma CenterUniversity of MarylandBaltimoreMD 21201United States

Extracorporeal membrane oxygenation(ECMO)has emerged as a vital circulatory life support measure for patients with critical cardiac or pulmonary conditions unresponsive to conventional *** allows blood to be extracted from a patient and introduced to a machine that oxygenates blood and removes carbon *** blood is then reintroduced into the patient’s circulatory *** process makes ECMO essential for treating various medical conditions,both as a standalone therapy and as adjuvant ***-venous(VV)ECMO primarily supports respiratory function and indicates respiratory ***,veno-arterial(VA)ECMO provides hemodynamic and respiratory support and is suitable for cardiac-related *** study reviews recent literature to elucidate the evolving role of ECMO in trauma care,considering its procedural intricacies,indications,contraindications,and associated ***,the use of ECMO in trauma patients,particularly for acute respiratory distress syndrome and cardiogenic shock,has demonstrated promising outcomes despite challenges such as anticoagulation management and complications such as acute kidney injury,bleeding,thrombosis,and *** studies have shown that VV ECMO was associated with significantly higher survival rates than conventional mechanical ventilation,whereas other studies have reported that VA ECMO was associated with lower survival rates than VV *** plays a critical role in managing trauma patients,particularly those with acute respiratory *** research is necessary to explore the full potential of ECMO in trauma *** should have a clear understanding of the indications and contraindications for the use of ECMO to maximize its benefits in treating trauma patients.

关键词： Extracorporeal membrane oxygenation treatments Multiple trauma Respiratory distress syndrome Cardiogenic shock Contraindications Anticoagulants

Diffuse cystic lung diseases

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Frontiers of medicine 2013年第3期7卷 316-327页

作者： Jay H.Ryu Xinlun Tian Misbah Baqir Kaifeng Xu division of pulmonary and critical care medicine Mayo ClinicRochesterMN 55905USA division of Respiratory medicine Peking Union Medical College HospitalBeijing 100730China

Diffuse cystic lung diseases are uncommon but can present a diagnostic challenge because increasing number of diseases have been associated with this *** in the lung is defined as a round parenchymal lucency with a well-defined thin wall(pulmonary lymphangioleiomyomatosis,pulmonary Langerhans’cell histiocytosis,lymphoid interstitial pneumonia,Birt-Hogg-Dubésyndrome,amyloidosis,light chain deposition disease,honeycomb lung associated with advanced fibrosis,and several other rare causes including metastatic ***-resolution computed tomography of the chest helps define morphologic features of the lung lesions as well as their distribution and associated features such as intrathoracic *** the tempo of the disease process and clinical context with chest imaging findings serve as important clues to defining the underlying nature of the cystic lung disease and guide diagnostic evaluation as well as management.

关键词： cyst lung disease interstitial lung disease lymphangioleiomyomatosis Langerhans’cell histiocytosis Birt-Hogg-Dubésyndrome

Lung function and air pollution exposure in adults with asthma in Beijing:a 2-year longitudinal panel study

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Frontiers of medicine 2022年第4期16卷 574-583页

作者： Jun Wang Wenshuai Xu Xinlun Tian Yanli Yang Shao-Ting Wang Kai-Feng Xu Department of pulmonary and critical care medicine Peking Union Medical College HospitalChinese Academy of Medical SciencesBeijing 100730China

The effect of air pollution on the lung function of adults with asthma remains unclear to *** study followed 112 patients with asthma at 3-month intervals for 2 *** pollutant exposure of the participants was estimated using the inverse distance weight *** participants were divided into three groups according to their lung function level at every visit.A linear mixed-effect model was applied to predict the change in lung function with each unit change in pollution *** to carbon monoxide(CO)and particles less than 2.5 micrometers in diameter(PM2.5)was negatively associated with large airway function in *** the severe group,exposure to chronic sulfur dioxide(SO2)was negatively associated with postbronchodilator forced expiratory flow at 50%,between 25%and 75%of vital capacity%predicted(change of 95%CI per unit:-0.34(-0.55,-0.12),-0.24(-0.44,-0.03),respectively).In the mild group,the effect of SO2 on the small airways was similar to that in the severe group,and it was negatively associated with large airway *** to CO and PM2.5 was negatively associated with the large airway function of adults with *** negative effects of SO2 were more evident and widely observed in adults with severe and mild asthma than in adults with moderate *** with asthma react differently to air pollutants as evidenced by their lung function levels.

关键词： lung function asthma air pollution adult

Risk factors for hepatic steatosis in adults with cystic fibrosis: Similarities to non-alcoholic fatty liver disease

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World Journal of Hepatology 2018年第1期10卷 34-40页

作者： Fares Ayoub Cesar Trillo-Alvarez Giuseppe Morelli Jorge Lascano Department of medicine University of Florida Department of medicine Division of Pulmonary Critical Care and Sleep Medicine University of Florida Department of medicine Division of Gas-troenterology Hepatology and Nutrition University of Florida Department of medicine Adult Cystic Fibrosis Center Division of Pulmonary Critical Care and Sleep Medicine University of Florida

AIM To investigate the clinical, biochemical and imaging characteristics of adult cystic fibrosis(CF) patients with hepatic steatosis as compared to normal CF *** We performed a retrospective review of adult CF patients in an academic outpatient setting during 2016. Baseline characteristics, genetic mutation analysis as well as laboratory values were collected. Abdominal imaging(ultrasound, computed tomography, magnetic resonance) was used to determine presence of hepatic steatosis. We compare patients with hepatic steatosis to normal *** Data was collected on 114 patients meeting inclusion criteria. Seventeen patients(14.9%) were found to have hepatic steatosis on imaging. Being overweight(BMI > 25)(P = 0.019) and having a higher pp FEV1(75 vs 53, P = 0.037) were significantly associated with hepatic steatosis. Patients with hepatic steatosis had a significantly higher median alanine aminotransferase level(27 vs 19, P = 0.048). None of the hepatic steatosis patients had frank CF liver disease, cirrhosis or portal hypertension. We found no significant association with pancreatic insufficiency or CF related *** Hepatic steatosis appears to be a clinically and phenotypically distinct entity from CF liver disease. The lack of association with malnourishment and the significant association with higher BMI and higher pp FEV1 demonstrate similarities with non-alcoholic fatty liver disease. Long term prospective studies are needed to ascertain whether CF hepatic steatosis progresses to fibrosis and cirrhosis.

关键词： Cystic fibrosis liver disease Hepatic steatosis Non-alcoholic fatty liver disease

Clinical trials for the treatment of coronavirus disease 2019(COVID-19):A rapid response to urgent need

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Science China(Life sciences) 2020年第5期63卷 774-776页

作者： Tengyue Zhang Yudi He Wenshuai Xu Aiping Ma Yanli Yang Kai-Feng Xu Department of Internal medicine Peking Union Medical College HospitalChinese Academy of Medical SciencesBeijing 100730China Department of pulmonary and critical care medicine Peking Union Medical College HospitalChinese Academy of Medical SciencesBeijing 100730China Department of pulmonary and critical care medicine The First Affiliated HospitalCollege of MedicineXiamen UniversityXiamen 361003China

Emerging coronavirus disease 2019,known as COVID-19,is caused by the newly identified SARS-CoV-2 *** the outbreak of COVID-19 in December 2019 in Wuhan(China),more than 70 thousand patients were *** disease resulted in 1,870 deaths by February 18,2020,according to the National Health Commission of People's Republic of China(http://***).

关键词： Clinical treatment COV

Microarray, SAGE and their applications to cardiovascular diseases

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Cell Research 2002年第2期12卷 105-115页

作者： SHUI QING YE, TERA LAVOIE, DAVID C USHER, LI Q. ZHANG1 division of pulmonary and critical care medicine, Johns Hopkins University, School of medicine, Baltimore, MD 21224, USA2Department of Biological Science, University of Delaware, Newark, DE 19716, USA 1division of pulmonary and critical care medicine Johns Hopkins University School of Medicine Baltimore MD 21224 USA 1division of pulmonary and critical care medicine Johns Hopkins University School of Medicine Baltimore MD 21224 USA 2Department of Biological Science University of Delaware Newark DE 19716 USA 3Department of Surgery University of Maryland Baltimore MD 21201 USA

The wealth of DNA data generated by the human genome project coupling with recently invented high-throughput gene expression profiling techniques has dramatically sped up the process for biomedical researchers on elucidating the role of genes in human diseases. One powerful method to reveal insight into gene functions is the systematic analysis of gene expression. Two popular high-throughput gene expression technologies, microarray and Serial Analysis of Gene Expression (SAGE) are capable of producing large amounts of gene expression data with the potential of providing novel insights into fundamental disease processes, especially complex syndromes such as cardiovascular disease, whose etiologies are due to multiple genetic factors and their interplay with the environment. Microarray and SAGE have already been used to examine gene expression patterns of cell-culture, animal and human tissues models of cardiovascular diseases. In this review, we will first give a brief introduction of microarray and SAGE

关键词： Microarray SAGE cardiovascular diseases RNA gene expression profiling.