Respiratory Therapy Leaders' Perceptions of Value of Respiratory Care Services.

Background: Respiratory care departments are experiencing an increased need to demonstrate value in the care they deliver. Value efficiency is a concept that incorporates the value of individual treatments into the normal operations of a department. The purpose of this study was to describe respiratory care leaders' attitudes about the value of services provided by respiratory care departments.

Feasibility of a Multi-Center Respiratory Therapist Endotracheal Intubation Study.

Background: Respiratory therapists (RTs) have historically performed safe and effective intubations, yet there are limited multi-center data assessing their intubation performance. Multi-center data can be used to compare RT intubation performance to that of other professions and identify quality improvement opportunities at hospitals where RTs perform intubation. We aimed to explore the feasibility of a multi-center collaborative to evaluate RT intubation outcomes.

Retrospective Review of Transpulmonary Pressure Guided Positive End-Expiratory Pressure Titration for Mechanical Ventilation in Class II and III Obesity.

Objectives: Acute respiratory distress syndrome is treated by utilizing a lung protective ventilation strategy. Obesity presents with additional physiologic considerations, and optimizing ventilator settings may be limited with traditional means. Transpulmonary pressure (P) obtained via esophageal manometry may be more beneficial to titrating positive end-expiratory pressure (PEEP) in this population.

Improving Tracheostomy Decannulation Rate In Trauma Patients.

Objective: Identify the effect of a multidisciplinary tracheostomy decannulation protocol (TDP) in the trauma population.

Design: Single center retrospective review.

Setting: American College of Surgeons Level 1 Trauma Center; large academic associated community hospital.

The Current State of Antimicrobial Stewardship: Challenges, Successes, and Future Directions.

Purpose Of Review: The aim of this study is to examine the current state of the field of antimicrobial stewardship (AS) by highlighting key challenges and successes, as well as exciting future directions.

Recent Findings: AS mandates from the Centers for Medicare and Medicaid (CMS) and the Joint Commission (TJC) will stimulate increased compliance with current AS standards, but overall compliance is currently poor. Key challenges to progress in the field of AS include insufficient workforce and monetary resources, poorly defined AS metrics, and much needed expansion beyond the inpatient hospital setting.

Defining the phylogenomics of Shigella species: a pathway to diagnostics.

Shigellae cause significant diarrheal disease and mortality in humans, as there are approximately 163 million episodes of shigellosis and 1.1 million deaths annually. While significant strides have been made in the understanding of the pathogenesis, few studies on the genomic content of the Shigella species have been completed.

Work of breathing indices in infants with respiratory insufficiency receiving high-flow nasal cannula and nasal continuous positive airway pressure.

Objective: To compare work of breathing (WOB) indices between two nCPAP settings and two levels of HFNC in a crossover study.

Study Design: Infants with a CGA 28-40 weeks, baseline of HFNC 3-5 lpm or nCPAP 5-6 cmH2O and fraction of inspired oxygen ≤40% were eligible. WOB was analyzed using respiratory inductive plethysmography (RIP) for each of the four modalities: HFNC 3 and 5 lpm, nCPAP 5 and 6 cmH2O.

Decreased incidence of pneumothorax in VLBW infants after increased monitoring of tidal volumes.

Background And Objective: Pneumothorax is common in very low birth weight (VLBW) infants. In our NICU, we noted an above average incidence of pneumothorax compared with similar NICUs based on Vermont Oxford Network benchmarking. The quality improvement project was designed to decrease the incidence of pneumothorax in VLBW infants in a tertiary care NICU.

Lung hernia associated with hemothorax following cardiopulmonary resuscitation.

Lung herniation is a rare event that can occur spontaneously or traumatically. Thoracic hernias are usually associated with a chest-wall defect. We report a case of thoracic lung hernia that occurred 2 days after traumatic cardiopulmonary resuscitation, after the formation of a large hemothorax.

Effect of inhaled corticosteroids on markers of pulmonary inflammation and lung maturation in preterm infants with evolving chronic lung disease.

Background: Chronic lung disease (CLD) is one of the most severely disabling conditions of extremely low-birth-weight infants. Systemic corticosteroids are effective but cause many adverse effects. Targeted therapy with inhaled corticosteroids may be an effective and less toxic alternative.

CD23 antigen density is related to serum gamma globulin level, bone marrow reticulin pattern, and treatment in B chronic lymphocytic leukemia.

The CD23 antigen density was evaluated by a cytofluorometric technique in 55 patients with chronic lymphocytic leukemia. The quantification method was based on the use of biological standards in indirect immunofluorescence. The CD23 antigen density was correlated with the percentage of CD23 positive cells, but antigen density appeared to be a more informative parameter.

Non-Hodgkin's lymphoma associated with primary Sjögren's syndrome.

Objectives: To evaluate the prevalence, the incidence and clinical presentation of non-Hodgkin's lymphoma associated with primary Sjögren's syndrome.

Methods: Sixty-two patients with primary Sjögren's syndrome were analyzed retrospectively in an open investigation.

Results: Of 62 patients with primary Sjögren's syndrome, 4 of them (6.

A study of 15 cases of primary mediastinal lymphoma of B-cell type.

Fifteen cases of pure supradiapragmatic lymphoma with initial prominent antero-superior mediastinal involvement displaying a B-cell pattern of reactivity were studied. These cases occurred in six men and nine women with a median age of 33 years at diagnosis (range, 23 to 75 years). Supradiapragmatic peripheral lymphadenopathies were present in three cases, and intrathoracic extension to the lung, pericardium, or pleura was possible.

Acute monocytic leukemia with B cell markers expression following B chronic lymphocytic leukemia.

A case of chronic lymphocytic leukemia (CLL) treated with chlorambucil, followed by the development of an acute monoblastic leukemia, is described. Cytofluorometric quantitative immunophenotype was determined during the blastic phase. Whereas small lymphocytes displayed a CD19+; CD24+; CD37+; CD5+ phenotype, the blastic population exhibited, besides CD13, CD14 and CD15 positivity, which is usually noted in such a monoblastic leukemia, definite CD9, CD10, CD22, CD24, CD37, CD5 and CD4 staining.

Specific 5 alpha-dihydrotestosterone receptor and 5 alpha-reductase activity in human amniotic fluid cells.

A macromolecular component which specifically binds tritium-labeled-dihydrotestosterone is present in cultured amniotic fluid cells. The androgen-binding complex is characterized by a 3.6S sedimentation coefficient, an apparent dissociation constant of 1 nmol/L, a mean binding capacity of 243 +/- 140 fmol/mg of DNA, and a specificity for testosterone and dihydrotestosterone.

[Study of caryotypes in 52 cases of chronic lymphocytic B-cell leukemia].

The karyotypes of 103 cases of B cell chronic lymphocytic leukemia were studied following stimulation or establishment of continuous cell lines using the Epstein-Barr virus. In 52 patients metaphases suitable for cytogenetic analysis were obtained; 30 revealed normal karyotypes and 22 abnormal karyotypes. The most frequently encountered abnormalities were 6 cases of extra chromosome 12, 4 cases of structured aberrations concerning chromosome 14, including 2 t(11;14), 4 translocations concerning chromosome 11, and 3 cases of extra chromosome 3.

[Idiopathic pulmonary hemosiderosis and celiac disease in a child. Case report].

An enteropathy with almost total atrophy of the villi was discovered in a 13-year old girl with idiopathic pulmonary haemosiderosis. Coeliac disease was strongly suspected but could not be proven. This case draws attention to the possible association of an idiopathic pulmonary haemosiderosis with a coeliac disease.

Isochromosome 17q in cell lines of two cases of B cell chronic lymphocytic leukemia.

The cytogenetic study of lymphocytes stimulated by EB virus in two cases of B-CLL revealed an isochromosome 17q. This abnormality, well known in CML during the stage of blastic transformation, may not be specific to myeloid proliferation as it is also observed in malignant lymphomas and B- or T-CLL. The anomaly does not appear to have the same prognostic nature as in CML.

11;14 translocations in lymphoproliferative disorders. An analysis of three cases.

Our paper reports 3 cases of (11;14) (q13;q32) translocation during two B-cell chronic lymphocytic leukemias and one B-cell diffuse centrocytic malignant lymphoma. Relating to this subject, we briefly review observations of 11;14 translocations during lymphoid hemopathies.

Karyotype analysis of B-lymphocytes transformed by Epstein-Barr virus in 21 patients with B cell chronic lymphocytic leukemia.

The karyotypes of 21 patients with chronic B cell leukemia were studied using lymphoblastoid cell lines obtained with the aid of the Epstein-Barr virus. Ten patients had a normal karyotype and eleven patients, an abnormal. There is no single characteristic anomaly, but certain types were more frequent, i.

[Hepatitis caused by Campylobacter coli (author's transl)].

Campylobacter coli is known to cause ulcerous enterocolitis, but hepatitis has not yet been reported. A 50-year-old woman without history of liver disease was admitted with diarrhoea, fever, poor general condition, subicterus and enlarged liver. Campylobacter coli was grown in haemoculture, and a specific antibiotic treatment resulted in complete cure.