Pub Date : 2024-07-11DOI: 10.12746/swrccc.v12i52.1341
Shengping Yang, G. Berdine
{"title":"Relative risk, odds ratio and hazard ratio","authors":"Shengping Yang, G. Berdine","doi":"10.12746/swrccc.v12i52.1341","DOIUrl":"https://doi.org/10.12746/swrccc.v12i52.1341","url":null,"abstract":"","PeriodicalId":22976,"journal":{"name":"The Southwest Respiratory and Critical Care Chronicles","volume":"91 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141835022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-29DOI: 10.12746/swrccc.v12i50.1283
A. Ratra, B. Songtanin, Dauod Arif, Kanak Das
Pancreatic pseudopapillary neoplasms are rare pancreatic tumors and have a female predominance. Clinical manifestations include abdominal pain and/or an abdominal mass. Some patients are asymptomatic, and the tumors are found incidentally on imaging. Endoscopic ultrasound with fine needle biopsy with pathological tissue remains the gold standard for diagnosis. The malignant potential is low, and surgery remains the standard treatment. Keywords: Solid pseudopapillary neoplasm, pancreatic tumor, pancreatic malignancy, endoscopic ultrasound
{"title":"Rare solid pseudopapillary neoplasm in a Caucasian man","authors":"A. Ratra, B. Songtanin, Dauod Arif, Kanak Das","doi":"10.12746/swrccc.v12i50.1283","DOIUrl":"https://doi.org/10.12746/swrccc.v12i50.1283","url":null,"abstract":"Pancreatic pseudopapillary neoplasms are rare pancreatic tumors and have a female predominance. Clinical manifestations include abdominal pain and/or an abdominal mass. Some patients are asymptomatic, and the tumors are found incidentally on imaging. Endoscopic ultrasound with fine needle biopsy with pathological tissue remains the gold standard for diagnosis. The malignant potential is low, and surgery remains the standard treatment. \u0000Keywords: Solid pseudopapillary neoplasm, pancreatic tumor, pancreatic malignancy, endoscopic ultrasound","PeriodicalId":22976,"journal":{"name":"The Southwest Respiratory and Critical Care Chronicles","volume":"46 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140488061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-29DOI: 10.12746/swrccc.v12i50.1273
A. Motes, Kenneth Nugent, Camilo Pena
Intravenous fluid administration is one of the most commonly used interventions in acutely ill patients. Almost all hospitalized patients receive intravenous fluids for either volume resuscitation or as diluents for drug administration. However, recent studies suggest that fluid overload is associated with acute kidney injury and that fluid administration beyond the volume needed to correct the fluid deficit is associated with increased morbidity, longer hospital stays, and mortality. The exact cause and effect underlying this association remains uncertain. Previous studies have reported a correlation between fluid overload and mortality in critically ill patients with acute respiratory distress syndrome, acute lung injury, sepsis, and acute kidney injury. In patients with acute kidney injury, a higher percentage of fluid overload has been associated with higher mortality and shorter ventilator-free days starting during the initial management in the intensive care unit. Similarly, in a large multicenter study, a positive fluid balance was an important factor associated with increased 60-day mortality in patients with acute kidney injury. This review analyzes the use of intravenous fluids and renal function, including types of intravenous fluid, cumulative fluid targets, endpoint hemodynamic indicators, and renal replacement therapy for acute kidney injury. Key words: volume status, intravenous fluids, fluid balance, acute kidney injury, volume excess
{"title":"Fluid management based on renal function considerations","authors":"A. Motes, Kenneth Nugent, Camilo Pena","doi":"10.12746/swrccc.v12i50.1273","DOIUrl":"https://doi.org/10.12746/swrccc.v12i50.1273","url":null,"abstract":"Intravenous fluid administration is one of the most commonly used interventions in acutely ill patients. Almost all hospitalized patients receive intravenous fluids for either volume resuscitation or as diluents for drug administration. However, recent studies suggest that fluid overload is associated with acute kidney injury and that fluid administration beyond the volume needed to correct the fluid deficit is associated with increased morbidity, longer hospital stays, and mortality. The exact cause and effect underlying this association remains uncertain. Previous studies have reported a correlation between fluid overload and mortality in critically ill patients with acute respiratory distress syndrome, acute lung injury, sepsis, and acute kidney injury. In patients with acute kidney injury, a higher percentage of fluid overload has been associated with higher mortality and shorter ventilator-free days starting during the initial management in the intensive care unit. Similarly, in a large multicenter study, a positive fluid balance was an important factor associated with increased 60-day mortality in patients with acute kidney injury. This review analyzes the use of intravenous fluids and renal function, including types of intravenous fluid, cumulative fluid targets, endpoint hemodynamic indicators, and renal replacement therapy for acute kidney injury. \u0000 \u0000Key words: volume status, intravenous fluids, fluid balance, acute kidney injury, volume excess","PeriodicalId":22976,"journal":{"name":"The Southwest Respiratory and Critical Care Chronicles","volume":"44 47","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140487514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Acute and chronic cholecystitis commonly occur during pregnancy. Hormonal changes during pregnancy put women at a higher risk of forming gallstones and biliary dyskinesia leading to disease. The standard of care for acute cholecystitis is to have an elective cholecystectomy within 48 hours. Extensive research exists on the current practice of performing a laparoscopic cholecystectomy in pregnancy. Based on our review of the current literature, there is only one report that details a robotic cholecystectomy performed on a pregnant patient. This report will detail the methods used to perform the surgery and steps taken to ensure the safety of mother and fetus. It will describe the unique circumstances surrounding the robotic technique used in this case and include the demographics and background of this patient, in an effort to promote this technique in future cases. Key words: obstetrics, acute cholecystitis, symptomatic cholelithiasis, pregnancy, laparoscopic cholecystectomy, robotic-assisted cholecystectomy
{"title":"Robotic-assisted cholecystectomy in the third trimester of pregnancy","authors":"Marvelyn Iweh, Seham Azzam, Jocelin Loewen, Christopher Wilhelm, Nathan Kragh, Basem Soliman","doi":"10.12746/swrccc.v12i50.1221","DOIUrl":"https://doi.org/10.12746/swrccc.v12i50.1221","url":null,"abstract":"Acute and chronic cholecystitis commonly occur during pregnancy. Hormonal changes during pregnancy put women at a higher risk of forming gallstones and biliary dyskinesia leading to disease. The standard of care for acute cholecystitis is to have an elective cholecystectomy within 48 hours. Extensive research exists on the current practice of performing a laparoscopic cholecystectomy in pregnancy. Based on our review of the current literature, there is only one report that details a robotic cholecystectomy performed on a pregnant patient. This report will detail the methods used to perform the surgery and steps taken to ensure the safety of mother and fetus. It will describe the unique circumstances surrounding the robotic technique used in this case and include the demographics and background of this patient, in an effort to promote this technique in future cases. \u0000 \u0000Key words: obstetrics, acute cholecystitis, symptomatic cholelithiasis, pregnancy, laparoscopic cholecystectomy, robotic-assisted cholecystectomy","PeriodicalId":22976,"journal":{"name":"The Southwest Respiratory and Critical Care Chronicles","volume":"15 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140488794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-29DOI: 10.12746/swrccc.v12i50.1271
Avantika Mallik, A. Motes, Drew Payne, Kenneth Nugent
Abstract Background: Patients with prior COVID-19 infections can develop persistent dyspnea and physical limitation. This may reflect chronic lung disease, chronic heart disease, or neuromuscular disease. Treatment approaches include pulmonary rehabilitation. This study analyzed the benefits of conventional pulmonary rehabilitation in patients with chronic symptoms following COVID-19 infections. Methods: Twenty-eight patients completed pulmonary rehabilitation at University Medical Center in Lubbock, Texas. The primary outcome was the time spent on four different types of exercise equipment during aerobic exercise sessions. Results: This study included 15 women and 13 men, with a mean age of 54.4 years. The racial distribution included 12 White patients, 10 Hispanic patients, and 6 Black patients. Ten patients had a smoking history, 19 patients used supplemental oxygen, 14 patients had hypertension, and 11 patients had diabetes. The median COPD Assessment Test (CAT) score was 21.5 (Q1, Q3: 17.5,29), the median Patient Health Questionnaire-9 (PHQ-9) score was 8 (Q1, Q3: 4.5,15.5), and the median Medical Research Council (MRC) score was 2. Twenty-six patients had the abnormal chest x-rays within 3 months of starting the rehabilitation program; these included 5 patients with focal interstitial infiltrates, 9 patients with diffuse interstitial infiltrates, 6 patients with focal opacities, and 6 patients with bilateral opacities. These patients completed 22.9 (Q1, Q3: 6.8,36) exercise sessions. There were statistically significant increases in all machine times on all 4 machines. Conclusion: This study indicates pulmonary rehabilitation can significantly increase aerobic activity levels in patients with prior COVID-19 infections. This improvement occurred in patients with important comorbidity, abnormal chest x-rays, and chronic oxygen supplementation requirements. Patients with prior COVID-19 infections and persistent respiratory symptoms should be referred to pulmonary rehabilitation. Key words: COVID-19, long COVID, rehabilitation
{"title":"Pulmonary rehabilitation in patients with prior COVID-19 infections","authors":"Avantika Mallik, A. Motes, Drew Payne, Kenneth Nugent","doi":"10.12746/swrccc.v12i50.1271","DOIUrl":"https://doi.org/10.12746/swrccc.v12i50.1271","url":null,"abstract":"Abstract \u0000Background: Patients with prior COVID-19 infections can develop persistent dyspnea and physical limitation. This may reflect chronic lung disease, chronic heart disease, or neuromuscular disease. Treatment approaches include pulmonary rehabilitation. This study analyzed the benefits of conventional pulmonary rehabilitation in patients with chronic symptoms following COVID-19 infections. \u0000Methods: Twenty-eight patients completed pulmonary rehabilitation at University Medical Center in Lubbock, Texas. The primary outcome was the time spent on four different types of exercise equipment during aerobic exercise sessions. \u0000Results: This study included 15 women and 13 men, with a mean age of 54.4 years. The racial distribution included 12 White patients, 10 Hispanic patients, and 6 Black patients. Ten patients had a smoking history, 19 patients used supplemental oxygen, 14 patients had hypertension, and 11 patients had diabetes. The median COPD Assessment Test (CAT) score was 21.5 (Q1, Q3: 17.5,29), the median Patient Health Questionnaire-9 (PHQ-9) score was 8 (Q1, Q3: 4.5,15.5), and the median Medical Research Council (MRC) score was 2. Twenty-six patients had the abnormal chest x-rays within 3 months of starting the rehabilitation program; these included 5 patients with focal interstitial infiltrates, 9 patients with diffuse interstitial infiltrates, 6 patients with focal opacities, and 6 patients with bilateral opacities. These patients completed 22.9 (Q1, Q3: 6.8,36) exercise sessions. There were statistically significant increases in all machine times on all 4 machines. \u0000Conclusion: This study indicates pulmonary rehabilitation can significantly increase aerobic activity levels in patients with prior COVID-19 infections. This improvement occurred in patients with important comorbidity, abnormal chest x-rays, and chronic oxygen supplementation requirements. Patients with prior COVID-19 infections and persistent respiratory symptoms should be referred to pulmonary rehabilitation. \u0000 \u0000Key words: COVID-19, long COVID, rehabilitation","PeriodicalId":22976,"journal":{"name":"The Southwest Respiratory and Critical Care Chronicles","volume":"13 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140488899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-29DOI: 10.12746/swrccc.v12i50.1253
Or Belkin, Luis Fernandez-Nava, Muneeza Sheikh, Alan Pang, Bettina Schmitz, Chris Vogt, Robert Johnston, Cooper Phillips
This study compared closed and open intensive care unit (ICU) models in terms of patient outcomes. Closed ICUs had reduced mortality rates, shorter lengths of stay, and lower healthcare-associated infection rates. Intensivists in closed ICUs contributed to better outcomes due to their expertise and competence. Enhanced interdisciplinary collaboration, improved communication, and coordination in closed ICUs led to higher patient and family satisfaction. In addition, closed ICUs were more cost-effective, with better resource use and reduced healthcare costs. Overall, closed ICU models have advantages in patient outcomes, better resource use, cost-effectiveness, and patient satisfaction compared to open ICU models. Key words: Intensive care unit, ICU, patient outcomes, resource utilization, quality of care.
{"title":"The benefits of a closed ICU: a systematic review","authors":"Or Belkin, Luis Fernandez-Nava, Muneeza Sheikh, Alan Pang, Bettina Schmitz, Chris Vogt, Robert Johnston, Cooper Phillips","doi":"10.12746/swrccc.v12i50.1253","DOIUrl":"https://doi.org/10.12746/swrccc.v12i50.1253","url":null,"abstract":"This study compared closed and open intensive care unit (ICU) models in terms of patient outcomes. Closed ICUs had reduced mortality rates, shorter lengths of stay, and lower healthcare-associated infection rates. Intensivists in closed ICUs contributed to better outcomes due to their expertise and competence. Enhanced interdisciplinary collaboration, improved communication, and coordination in closed ICUs led to higher patient and family satisfaction. In addition, closed ICUs were more cost-effective, with better resource use and reduced healthcare costs. Overall, closed ICU models have advantages in patient outcomes, better resource use, cost-effectiveness, and patient satisfaction compared to open ICU models. \u0000 \u0000Key words: Intensive care unit, ICU, patient outcomes, resource utilization, quality of care.","PeriodicalId":22976,"journal":{"name":"The Southwest Respiratory and Critical Care Chronicles","volume":"86 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140487880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-29DOI: 10.12746/swrccc.v12i50.1285
Barbara Mora, Jacob Nichols
{"title":"Leishmaniasis is now considered an endemic pathogen in Texas","authors":"Barbara Mora, Jacob Nichols","doi":"10.12746/swrccc.v12i50.1285","DOIUrl":"https://doi.org/10.12746/swrccc.v12i50.1285","url":null,"abstract":"","PeriodicalId":22976,"journal":{"name":"The Southwest Respiratory and Critical Care Chronicles","volume":"25 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140490269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-29DOI: 10.12746/swrccc.v12i50.1275
Kenneth Nugent, G. Berdine
Mechanical ventilation provides lifesaving support for patients with acute respiratory failure. However, the pressures and volumes required to maintain gas exchange can cause ventilator-induced lung injury. The current approach to mechanical ventilation involves attention to both tidal volume and airway pressures, in particular plateau pressures and driving pressures. The ventilator provides energy to overcome airway resistance and to inflate alveolar structures. This energy delivered to the respiratory system per unit time equals mechanical power. Calculation of mechanical power provides a composite number that integrates pressures, volumes, and respiratory rates. Increased levels of mechanical power have been associated with tissue injury in animal models. In patients, mechanical power can predict outcomes, such as ICU mortality, when used in multivariable analyses. Increases in mechanical power during the initial phase of ventilation have been associated with worse outcomes. Mechanical power calculations can be used in patients on noninvasive ventilation, and measurements of mechanical power have been used to compare ventilator modes. Calculation of mechanical power requires measurement of the area in a hysteresis loop. Alternatively, simplified formulas have been developed to provide this calculation. However, this information is not available on most ventilators. Therefore, clinicians will need to make this calculation. In summary, calculation of mechanical power provides an estimate of the energy requirements for mechanical ventilation based on a composite of factors, including airway resistance, lung elastance, respiratory rate, and tidal volume. Key words: mechanical ventilation, mechanical power, ventilator-induced lung injury, energy, work
{"title":"Mechanical power during mechanical ventilation","authors":"Kenneth Nugent, G. Berdine","doi":"10.12746/swrccc.v12i50.1275","DOIUrl":"https://doi.org/10.12746/swrccc.v12i50.1275","url":null,"abstract":"Mechanical ventilation provides lifesaving support for patients with acute respiratory failure. However, the pressures and volumes required to maintain gas exchange can cause ventilator-induced lung injury. The current approach to mechanical ventilation involves attention to both tidal volume and airway pressures, in particular plateau pressures and driving pressures. The ventilator provides energy to overcome airway resistance and to inflate alveolar structures. This energy delivered to the respiratory system per unit time equals mechanical power. Calculation of mechanical power provides a composite number that integrates pressures, volumes, and respiratory rates. Increased levels of mechanical power have been associated with tissue injury in animal models. In patients, mechanical power can predict outcomes, such as ICU mortality, when used in multivariable analyses. Increases in mechanical power during the initial phase of ventilation have been associated with worse outcomes. Mechanical power calculations can be used in patients on noninvasive ventilation, and measurements of mechanical power have been used to compare ventilator modes. Calculation of mechanical power requires measurement of the area in a hysteresis loop. Alternatively, simplified formulas have been developed to provide this calculation. However, this information is not available on most ventilators. Therefore, clinicians will need to make this calculation. In summary, calculation of mechanical power provides an estimate of the energy requirements for mechanical ventilation based on a composite of factors, including airway resistance, lung elastance, respiratory rate, and tidal volume. \u0000 \u0000Key words: mechanical ventilation, mechanical power, ventilator-induced lung injury, energy, work ","PeriodicalId":22976,"journal":{"name":"The Southwest Respiratory and Critical Care Chronicles","volume":"43 19","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140487541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-29DOI: 10.12746/swrccc.v12i50.1277
Walter R Duarte-Celada, Samathorn Thakolwiboon, Jie Pan, Tulio Bueso, Jannatul Ferdous
Cefepime-induced non-convulsive status epilepticus (NCSE) can develop in patients with advanced age, renal impairment, and previous central nervous system disorders. Its clinical presentation varies from confusion, mutism, and decreased level of consciousness to coma. The typical electroencephalogram (EEG) findings are generalized spike and wave discharges of 1-3 Hz. We present a case series of 4 patients with cefepime-induced NCSE, including the clinical presentation and EEG findings. Electroencephalograms should be part of the workup of acute confusional state in patients on this antibiotic, and physicians should be aware of this uncommon complication. Keywords: Non-convulsive status epilepticus, cefepime, confusion, mutism, electroencephalogram.
{"title":"Cefepime-induced non-convulsive status epilepticus","authors":"Walter R Duarte-Celada, Samathorn Thakolwiboon, Jie Pan, Tulio Bueso, Jannatul Ferdous","doi":"10.12746/swrccc.v12i50.1277","DOIUrl":"https://doi.org/10.12746/swrccc.v12i50.1277","url":null,"abstract":"Cefepime-induced non-convulsive status epilepticus (NCSE) can develop in patients with advanced age, renal impairment, and previous central nervous system disorders. Its clinical presentation varies from confusion, mutism, and decreased level of consciousness to coma. The typical electroencephalogram (EEG) findings are generalized spike and wave discharges of 1-3 Hz. We present a case series of 4 patients with cefepime-induced NCSE, including the clinical presentation and EEG findings. Electroencephalograms should be part of the workup of acute confusional state in patients on this antibiotic, and physicians should be aware of this uncommon complication. \u0000 \u0000Keywords: Non-convulsive status epilepticus, cefepime, confusion, mutism, electroencephalogram.","PeriodicalId":22976,"journal":{"name":"The Southwest Respiratory and Critical Care Chronicles","volume":"183 1-2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140490032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：