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Hepatobiliary Dysfunction and Disseminated Intravascular Coagulation Increase Risk of Mortality in Pediatric Hemophagocytic Lymphohistiocytosis*
Objectives: Hemophagocytic lymphohistiocytosis poses significant challenges due to limited tools to guide clinical decisions in a population at high risk of death. We sought to assess whether disseminated intravascular coagulation and hepatobiliary dysfunction, significant comorbidities seen in critical care settings, would identify hemophagocytic lymphohistiocytosis patients with increased risk of mortality. Design: Retrospective chart review. Setting: Single-center PICU. Patients: All patients admitted to a tertiary care children’s hospital diagnosed with hemophagocytic lymphohistiocytosis from 2005 to 2012....
Source: Pediatric Critical Care Medicine - October 1, 2018 Category: Pediatrics Tags: Online Clinical Investigations Source Type: research

A review of associated controversies surrounding glucocorticoid use in veterinary emergency and critical care
Abstract ObjectiveTo review the literature in human and veterinary medicine regarding the indications for, efficacy of, and controversies surrounding glucocorticoid (GC) administration in the emergency and critical care (ECC) setting, and to provide an overview of the most commonly used synthetic GC formulations. MedicationsSynthetic GCs vary in GC and mineralocorticoid potency, hypothalamic pituitary axis suppression, duration of action, route of administration, and clinical indication for use. Some of the GC compounds commonly used in human and veterinary ECC include hydrocortisone, prednisone, methylprednisolone, and de...
Source: Journal of Veterinary Emergency and Critical Care - March 1, 2017 Category: Veterinary Research Authors: Maya A. Aharon, Jennifer E. Prittie, Kate Buriko Tags: Clinical Practice Review Source Type: research

Specialist pediatric palliative care prescribing practices: A large 5-year retrospective audit
Conclusions: Audit of the prescribing practices in specialist pediatric palliative care service shows that knowledge of pediatric palliative care formulary, rational drug use, dosing, and prescribing guidelines is essential for symptom control in children with advanced life-limiting illness. Noncompliance to WHO prescribing guidelines in one fourth of cases and using nongeneric names in two-thirds of prescription indicates poor prescribing practices and warrants prescriber education. Prescription noncompliance by almost two-thirds of patients is alarming and necessitates intense patient, family, and caregiver education and empowerment.
Source: Indian Journal of Palliative Care - June 29, 2016 Category: Palliative Care Authors: Anuja DamaniNaveen SalinsArunangshu GhoshalMaryAnn Muckaden Source Type: research

Role of TL1A/DR3 Axis in the Activation of ILC2s in Eosinophilic Asthmatics.
CONCLUSIONS: The TL1A/DR3 axis is a co-stimulator of ILC2s in asthma, particularly in the airways of patients with a predisposition to autoimmune responses. PMID: 32584596 [PubMed - as supplied by publisher]
Source: American Journal of Respiratory and Critical Care Medicine - June 24, 2020 Category: Respiratory Medicine Authors: Machida K, Aw M, Salter BM, Ju X, Mukherjee M, Gauvreau GM, O'Byrne PM, Nair P, Sehmi R Tags: Am J Respir Crit Care Med Source Type: research

Impaired Nuclear Translocation of the Glucocorticoid Receptor in Corticosteroid-insensitive Airway Smooth Muscle in Severe Asthma.
Conclusions: Decreased GR expression with impaired nuclear translocation in ASMC, associated with reduced dexamethasone-mediated attenuation of p65 recruitment to NFκB-dependent gene promoters, may underlie CS insensitivity of severe asthma. Agents that improve GR nuclear translocation may lead to improved corticosteroid sensitivity in severe asthma. PMID: 25411910 [PubMed - as supplied by publisher]
Source: American Journal of Respiratory and Critical Care Medicine - November 20, 2014 Category: Respiratory Medicine Authors: Chang PJ, Michaeloudes C, Zhu J, Shaikh N, Baker J, Chung KF, Bhavsar PK Tags: Am J Respir Crit Care Med Source Type: research

Allergen-induced Increases in Sputum Levels of Group 2 Innate Lymphoid Cells in Asthmatic Subjects.
CONCLUSIONS: Both innate and adaptive immune cells are increased in the airways associated with allergic asthmatic responses. Total and type 2 cytokine positive ILC2s are increased only within the airways whereas CD4+ T lymphocytes demonstrated local and systemic increases. Steroid sensitivity of both cells may explain effectiveness of this therapy in mild asthmatics. PMID: 28422515 [PubMed - as supplied by publisher]
Source: American Journal of Respiratory and Critical Care Medicine - April 19, 2017 Category: Respiratory Medicine Authors: Chen R, Smith SG, Salter B, El-Gammal A, Oliveria JP, Obminski C, Watson R, O'Byrne PM, Gauvreau GM, Sehmi R Tags: Am J Respir Crit Care Med Source Type: research

Circulating MicroRNAs and Treatment Response in Childhood Asthma.
CONCLUSIONS: We identified two functional circulating miRNAs predictive of asthma ICS treatment response over time. PMID: 32272022 [PubMed - as supplied by publisher]
Source: American Journal of Respiratory and Critical Care Medicine - April 8, 2020 Category: Respiratory Medicine Authors: Li J, Panganiban R, Kho AT, McGeachie MJ, Farnam L, Chase RP, Weiss ST, Lu Q, Tantisira KG Tags: Am J Respir Crit Care Med Source Type: research

Global Initiative for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease: The 2020 GOLD Science Committee Report on COVID-19 & COPD.
This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/). PMID: 33146552 [PubMed - as supplied by publisher]
Source: American Journal of Respiratory and Critical Care Medicine - November 4, 2020 Category: Respiratory Medicine Authors: Halpin DMG, Criner GJ, Papi A, Singh D, Anzueto A, Martinez FJ, Agusti AA, Vogelmeier CF, GOLD Science Committee Tags: Am J Respir Crit Care Med Source Type: research

Research and Reviews in the Fastlane 053
This study combines the results from the WARFASA and ASPIRE trials looking at aspirin prophylaxis. The results are promising. Aspirin 100 mg reduced the rate of recurrent VTE from 7.5%/year to 5.1%/year (HR = 0.68) without a significant change in bleeding rate (0.5%/year vs 0.4%/year). We often see patients in the ED with a history of unprovoked VTE who are on no long-term prophylaxis. This article argues that we consider aspirin for all these patients. Recommended by: Anand Swaminathan Trauma Stevens AC, Trammell TR, Billows GL, Ladd LM, Olinger ML. Radiation Exposure as a Consequence of Spinal Immobilization and Extri...
Source: Life in the Fast Lane - October 14, 2014 Category: Emergency Medicine Authors: Nudrat Rashid Tags: Alternative Medicine Anaesthetics Cardiology Education Emergency Medicine Haematology Intensive Care Neurology Pediatrics R&R in the FASTLANE Respiratory Resuscitation Toxicology and Toxinology Trauma critical care literature Source Type: blogs

Research and Reviews in the Fastlane 071
This study looks at the effect of institution of duty hour restrictions on the outcome of Medicare patients. Although the study is retrospective and derived from large database information, it gives us a peak into the bigger picture of duty hours regulations: patient outcomes. The study authors found no difference in any important outcomes. It is similarly unclear whether these restrictions have improved resident quality of education or quality of life. Large system wide changes duty hour restrictions should, in the future, be implemented not based on theory but actual data of improved outcomes. An accompanying editorial d...
Source: Life in the Fast Lane - February 18, 2015 Category: Emergency Medicine Authors: Soren Rudolph Tags: Education Emergency Medicine Neurosurgery Pediatrics Resuscitation Trauma critical care examination Intensive Care R&R in the FASTLANE research and reviews Source Type: blogs

Implementation of a Prehospital Protocol Change For Asthmatic Children.
CONCLUSIONS: Prehospital protocol change for asthmatic children is associated with shorter total hospital and total care times. This protocol change was also associated with decreased hospitalization rates and less need for critical care in those hospitalized. Further study is necessary to determine if other factors also contributed. PMID: 29351496 [PubMed - as supplied by publisher]
Source: Prehospital Emergency Care - January 20, 2018 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Dexamethasone Versus Prednisone for Pediatric Acute Asthma Exacerbations: Specialists' Practice Patterns
Conclusions Although most pediatric emergency medicine academic physicians have transitioned to using dexamethasone to treat acute pediatric asthma exacerbations, other specialties continue to favor prednisone.
Source: Pediatric Emergency Care - July 1, 2021 Category: Emergency Medicine Tags: Original Articles Source Type: research

French Intensive Care Society, International congress - Réanimation 2016.
C, Sauneuf B, Verrier P, Pottier V, Orabona M, Samba D, Viquesnel G, Lermuzeaux M, Hazera P, Hanouz JL, Parienti JJ, Du Cheyron D, Demoule A, Clavel M, Rolland-Debord C, Perbet S, Terzi N, Kouatchet A, Wallet F, Roze H, Vargas F, Guérin C, Dellamonica J, Jaber S, Similowski T, Quenot JP, Binquet C, Vinsonneau C, Barbar SD, Vinault S, Deckert V, Lemaire S, Hssain AA, Bruyère R, Souweine B, Lagrost L, Adrie C, Jung B, Daurat A, De Jong A, Chanques G, Mahul M, Monnin M, Molinari N, Lheureux O, Trepo E, Hites M, Cotton F, Wolff F, Surin R, Créteur J, Vincent JL, Gustot T, Jacobs F, Taccone FS, Neuville M, Timsit JF, El-Hel...
Source: Australian Family Physician - May 31, 2016 Category: Primary Care Authors: Jaillette E, Girault C, Brunin G, Zerimech F, Chiche A, Broucqsault-Dedrie C, Fayolle C, Minacori F, Alves I, Barrailler S, Robriquet L, Delaporte E, Thellier D, Delcourte C, Duhamel A, Nseir S, Valette X, Desmeulles I, Savary B, Masson R, Seguin A, Daubi Tags: Ann Intensive Care Source Type: research

Intraoperative period
Publication date: Available online 16 March 2018 Source:Anaesthesia Critical Care & Pain Medicine Author(s): Working party approved by the French Society of Anaesthesia and Intensive Care Medicine (SFAR) the French Society for the study of Diabetes (SFD)GaëlleCheissonSophieJacqueminetEmmanuelCossonCaroleIchaiAnne-MarieLeguerrierBogdanNicolescu-CatargiAlexandreOuattaraIgorTauveronPaulValensiDanBenhamouCorresponding author. Perioperative hyperglycaemia (>1.80g/L or 10mmol/L) increases morbidity (particularly due to infection) and mortality. Hypoglycaemia can be managed in the perioperative period by decreasi...
Source: Anaesthesia, Critical Care and Pain Medicine - April 18, 2018 Category: Anesthesiology Source Type: research

A survey of the administration of prednisolone versus ibuprofen analgesic protocols after ambulatory tonsillectomy
Conclusion The administration of ibuprofen compared to prednisolone improves postoperative comfort in children undergoing ambulatory tonsillectomy without increasing the incidence of side effects.
Source: Anaesthesia, Critical Care and Pain Medicine - December 1, 2015 Category: Anesthesiology Source Type: research