Temporary transvenous diaphragm pacing vs. standard of care for weaning from mechanical ventilation: study protocol for a randomized trial.

Background: Mechanical ventilation (MV) is a life-saving technology that restores or assists breathing. Like any treatment, MV has side effects. In some patients it can cause diaphragmatic atrophy, injury, and dysfunction (ventilator-induced diaphragmatic dysfunction, VIDD).

Atypical posterior reversible encephalopathy syndrome (PRES): is peritoneal dialysis a risk factor?

A patient with diabetes mellitus who had recently been started on peritoneal dialysis presented with headaches, confusion, falling episodes, and multiple white matter abnormalities affecting the frontal, temporal, parietal, and occipital lobes on MRI of the brain. He developed stupor and frequent seizures despite control of hypertension with intravenous nicardipine. Diagnosis of atypical PRES and institution of successful empiric therapy was based on electronic searches (Google and MEDLINE) facilitated by verbal communication between and among the specialists involved in his care.

Mortality before and after initiation of a computerized physician order entry system in a critically ill pediatric population.

Objective: A worrisome increase in mortality has been reported recently following the initiation of a computerized physician order entry (CPOE) system in a critically ill pediatric transport population. We tested the hypothesis that such a mortality increase did not occur after the initiation of CPOE in a pediatric population that was directly admitted to the neonatal and pediatric intensive care units at Montefiore Medical Center during two 6-month periods before CPOE and one 6-month period immediately after CPOE was initiated. Mortality in the pre- and post-CPOE time periods was compared, and adjustment for potentially confounding covariates was performed.

Optimization of lung function before pulmonary resection: pulmonologists' perspectives.

Many risk factors for morbidity and mortality with lung resection have been identified. Factors such as age, gender, and cancer stage cannot be altered, but lung function can be optimized by treating COPD or asthma with bronchodilators, corticosteroids, or antibiotics (when indicated) and by inspiratory muscle training. Although smoking cessation 2 months in advance of surgery may not be feasible, cessation nevertheless should be encouraged because it may decrease postoperative inflammation and in the long-term may decrease the risk of recurrence.