National Trends in Incidence and Outcomes of Patients With Heart Failure Requiring Respiratory Support.

Despite increasing medical complexity in patients with heart failure (HF), there are limited data on incidence and outcomes for patients with HF needing respiratory support. This study sought to examine contemporary trends of respiratory support strategies among patients with HF. Using the National Inpatient Sample, we identified adults aged greater than 18 years hospitalized with a primary diagnosis of HF.

Isolated Pulmonic Valve Endocarditis.

BACKGROUND Infective endocarditis (IE) has a high mortality rate, even when treated with appropriate antibiotic therapy and surgical intervention. Right-sided endocarditis is in itself rare, with some studies reporting an incidence of 5-10%. The majority of these cases involve the tricuspid valve, and isolated pulmonary valve endocarditis (PVE) is an extremely rare entity affecting less than 2% of patients with infective endocarditis.

Results of a Quality Improvement Project Aimed at Eliminating Healthcare Waste by Changing Medical Resident Test Ordering Behavior.

Background: In light of rising healthcare costs and evidence of inefficient use of medical resources, there is growing interest in reducing healthcare waste by clinicians. Unwarranted lab tests may lead to further tests, prolonged hospital stays, unnecessary referrals and procedures, patient discomfort, and iatrogenic anemia, resulting in significant economic and clinical effects. Blood tests are essential in guiding medical decisions, but they are also associated with significant financial and clinical costs.

Wine, spirits and the lung: good, bad or indifferent?

The putative cardiovascular risks and benefits of the ingestion of wine and alcohol-containing spirits have been well publicized; however, less attention has been focused upon the health effects of wine and spirits consumption on the respiratory system. This paper will highlight epidemiologic, clinical and experimental data on the effects of wine and distilled spirits [and the chemical components thereof] on lung function, chronic obstructive pulmonary disease progression, lung cancer risk, risk of developing acute respiratory distress syndrome, high altitude pulmonary edema and wine [sulfite] associated asthma. Several studies have demonstrated a positive [beneficial] effect of light-to-moderate wine consumption on pulmonary function, while chronic ingestion of distilled spirits may have either no effect, or a negative effect.

Pulmonary and cardiovascular consequences of smoking.

The extensive worldwide disease burden attributable to tobacco smoking is reviewed, with particular attention to the epidemiologic and clinical aspects, molecular and cellular mechanisms, and pathophysiology of a variety of smoking-related pulmonary diseases, and the epidemiology and clinical presentation of smoking-related atherosclerotic disease as it affects the cardiovascular system cerebral circulation, the aorta, and the peripheral arterial tree.

Ventilator strategy for status asthmaticus in pregnancy: a case-based review.

Asthma is a common and potentially serious condition complicating pregnancy. However, the literature available on the management of severe asthma in pregnancy is limited. We describe two episodes of respiratory failure due to asthma in pregnant women and discuss their management in the context of a review of the literature.

Pulmonary and cardiovascular consequences of smoking.

The extensive worldwide disease burden attributable to tobacco smoking is reviewed, with particular attention to the epidemiologic and clinical aspects, molecular and cellular mechanisms, and pathophysiology of a variety of smoking-related pulmonary diseases, and the epidemiology and clinical presentation of smoking-related atherosclerotic disease as it affects the cardiovascular system cerebral circulation, the aorta, and the peripheral arterial tree.

Drug resistant tuberculosis.

The emergence of multidrug resistant (MDR) strains of Mycobacterium tuberculosis (MDR-TB) represents a serious worldwide threat to the health of mankind. Approximately 2 billion persons are infected with Mycobacterium tuberculosis, and 8.8 million new cases of tuberculosis occur annually, with over 50,000 attributable deaths each week! Drug resistance is either acquired with the initial infection (from a host harboring resistant tubercle bacilli) or develops during treatment with antituberculous chemotherapeutic agents because of poor patient compliance or inadequate/inappropriate treatment regimens.

Laboratory studies in cross-species lung transplantation.

The lack of sufficient suitable human donor lungs for the many patients requiring pulmonary transplantation as life-saving therapy for end-stage lung diseases has generated extensive interest in cross-species lung transplantation. Ethical concerns and those of animal rights advocates have prompted studies of nonprimate species as potential solid organ donors for humans. This paper provides an overview of some of the laboratory studies of cross-species pulmonary transplantation performed over the past 20 years and focuses, in particular, on more recent work (from our laboratory and others) in the area of porcine-to-primate pulmonary xenotransplantation.

Resurgence of tuberculosis: the perspective a dozen years later.

More than a dozen years ago, case rates of tuberculosis (TB) began to increase in the United States, as well as in other industrialized and Third World countries. Our US urban centers were the epicenter of the "new" TB epidemic, with New York City accounting for more than 15% of all TB cases in the United States. Numerous factors were responsible for this dramatic, unexpected explosion in mankind's most prevalent and lethal disease, including (1) an increasing pool of susceptible individuals who, by virtue of human immunodeficiency virus (HIV) infection, were much more likely to rapidly progress to active (contagious) TB after becoming infected with Mycobacterium tuberculosis; (2) a reduction in the resources and sites available for the identification, treatment, and surveillance of patients with tuberculous infection and disease; and (3) the importation of TB cases via immigration.

Fiberoptic bronchoscopy in the presence of space-occupying intracranial lesions.

The performance of flexible fiberoptic bronchoscopy (FFB) has anecdotally been considered to carry a high risk of neurologic complications in patients with raised intracranial pressure (ICP). There is no evidence in the literature to support this concern. We evaluated this risk by reviewing hospital records of 132 patients who underwent FFB and computer tomography of the central nervous system (CNS-CT) during the same hospitalization.

Cardiopulmonary responses to continuous positive airway pressure in acute asthma.

The effects of nasal continuous positive airway pressure (CPAP) on expiratory flow, arterial blood gas tensions, cardiovascular status, and dyspnea were studied in 21 patients with acute asthma. Therapy consisted of the following CPAP sequence: 30 minutes at 5 cm H2O, 20 minutes at 0 cm H2O, 30 minutes at 7.5 cm H2O, and 20 minutes at 0 cm H2O.

Drug-resistant tuberculosis in an urban population including patients at risk for human immunodeficiency virus infection.

In the past 5 yr, an increased incidence of tuberculosis has been noted in the United States. Simultaneously, the population infected with human immunodeficiency virus-type I (HIV-I) and the number of cases of acquired immunodeficiency syndrome (AIDS) have increased. Selected areas of the United States have also reported increases in the frequency of drug-resistant isolates of Mycobacterium tuberculosis.