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Clinical applications of targeted temperature management.
Abstract Targeted temperature management (TTM) has been investigated experimentally and used clinically for over 100 years. The initial rationale for the clinical application of TTM, historically referred to as therapeutic hypothermia, was to decrease the metabolic rate, allowing the injured brain time to heal. Subsequent research demonstrated the temperature dependence of diverse cellular mechanisms including endothelial dysfunction, production of reactive oxygen species, and apoptosis. Consequently, modern use of TTM centers on neuroprotection following focal or global neurologic injury. Despite a solid basic sc...
Source: Chest - February 1, 2014 Category: Respiratory Medicine Authors: Perman SM, Goyal M, Neumar RW, Topjian AA, Gaieski DF Tags: Chest Source Type: research

Acute exacerbation in COPD: we must do more
If one asks medical students which emergencies they hold as especially important in internal medicine, more than 90% first mention myocardial infarction and stroke. This is not surprising, because these diseases occupy the first places in the mortality statistics contained in the Global Burden of Disease report [1]. Nevertheless, respiratory failure is only described as rare, despite the fact that chronic obstructive pulmonary disease (COPD) is ranked fifth and pneumonia seventh in the same report. While the high hospital mortality rate of myocardial infarction and stroke is well known, the risk of acute exacerbation of CO...
Source: European Respiratory Journal - December 31, 2015 Category: Respiratory Medicine Authors: Welte, T. Tags: COPD and smoking Editorials Source Type: research

Avoiding unnecessary arterial blood sampling in COPD exacerbations: a stab in the right direction
Hospital admissions for exacerbations are major events in the lives of people with COPD. The prognosis for such patients is grim. Around one in seven will die within 3 months of admission, and fewer than half will still be alive at 5 years.1 2 The symptoms they experience are frightening and unpleasant,3 their quality of life is reduced4 and the restriction in their physical activity, which may persist for weeks after the onset of symptoms, increases the risk that they will become housebound.5 In comparison with other medical emergencies, such as myocardial infarction and stroke, progress in improving the managem...
Source: Thorax - February 15, 2016 Category: Respiratory Medicine Authors: Hitchings, A. W., Baker, E. H. Tags: Editorial Source Type: research

High thrombotic risk increases adverse clinical events up to 5 years after acute myocardial infarction. A nationwide retrospective cohort study.
Authors: Mureddu GF, Greco C, Rosato S, D'Errigo P, De Luca L, Badoni G, Faggiano P, Seccareccia F Abstract The risk of recurrent events among survivors of acute myocardial infarction (AMI) is understudied. The aim of this analysis was to investigate the role of residual high thrombotic risk (HTR) as a predictor of recurrent in-hospital events after AMI. This retrospective cohort study included 186,646 patients admitted with AMI from 2009 to 2010 in all Italian hospitals who were alive 30 days after the index event. HTR was defined as at least one of the following in the 5 years preceding AMI: previous myocardial i...
Source: Monaldi Archives for Chest Disease - November 22, 2019 Category: Respiratory Medicine Tags: Monaldi Arch Chest Dis Source Type: research

Effect of obstructive sleep apnoea and its treatment with continuous positive airway pressure on the prevalence of cardiovascular events in patients with acute coronary syndrome (ISAACC study): a randomised controlled trial
This study is registered with Clinicaltrials.gov, NCT01335087 and is now closed.FindingsBetween April 25, 2011, and Feb 2, 2018, a total of 2834 patients with ACS had respiratory polygraphy, of whom 2551 (90·01%) were recruited. 1264 (49·55%) patients had OSA and were randomly assigned to the CPAP group (n=633) or the UC group (n=631). 1287 (50·45%) patients did not have OSA, of whom 603 (46·85%) were randomly assigned to the reference group. Patients were followed up for a median of 3·35 years (IQR 1·50–5·31). The prevalence of cardiovascular events was similar in the CPAP and UC groups (98 events [16%] vs 108 ev...
Source: The Lancet Respiratory Medicine - December 14, 2019 Category: Respiratory Medicine Source Type: research

Integrating the STOP-BANG score and clinical data to predict cardiovascular events after infarction: A machine learning study.
Abstract BACKGROUND: Obstructive sleep apnea (OSA) conveys worse clinical outcomes in coronary artery disease patients. The STOP-BANG score is a simple tool that evaluates the risk of OSA and can be added to the large number of clinical variables and scores obtained during the management of myocardial infarction (MI) patients. Currently, machine learning (ML) is able to select and integrate numerous variables to optimize prediction tasks. RESEARCH QUESTION: Can the integration of STOP-BANG score with clinical data and scores through ML better identify patients who suffered an in-hospital cardiovascular event ...
Source: Chest - April 24, 2020 Category: Respiratory Medicine Authors: Calvillo-Argüelles O, Sierra-Fernández CR, Padilla-Ibarra J, Rodriguez-Zanella H, Balderas-Muñoz K, Arias-Mendoza MA, Martínez-Sánchez C, Selmen-Chattaj S, Dominguez-Mendez BE, van der Harst P, Juarez-Orozco LE Tags: Chest Source Type: research

Pulmonary Embolism
Pneumologie. 2021 Oct;75(10):800-818. doi: 10.1055/a-1029-9937. Epub 2021 Oct 18.ABSTRACTPulmonary embolism (PE) is a life-threatening disease and the third most frequent cardiovascular cause of death after stroke and myocardial infarction. The annual incidence is increasing (in Germany from 85 cases per 100000 population in the year 2005 to 109 cases per 100000 population in the year 2015). The individual risk for PE-related complications and death increases with the number of comorbidities and severity of right ventricular dysfunction. Using clinical, laboratory and imaging parameters, patients with PE can be stratified ...
Source: Pneumologie - October 18, 2021 Category: Respiratory Medicine Authors: Lukas Hobohm Mareike Lankeit Source Type: research