The clinical respiratory journal
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We aimed to determine the incidence and the prognostic impact [mortality and length of intensive care unit (ICU) stay (LOS)] of pulmonary embolism (PE) in critically ill patients with severe acute exacerbation of chronic obstructive pulmonary disease (COPD). ⋯ Our study showed that PE is common in patients with severe COPD exacerbation requiring ICU admission. Moreover, PE was significantly associated with higher mortality and ICU LOS in critically ill patients with severe COPD exacerbation.
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Mycoplasma pneumoniae (MP) is a common childhood pathogen associated with atypical pneumonia (AP). It is often a mild disease and seldom results in paediatric intensive care (PICU) admission. In 2003, World Health Organization (WHO) coined the word SARS (severe acute respiratory syndrome) in patients with severe acute respiratory symptoms (sars) for an outbreak of AP in Hong Kong due to a novel coronavirus. In 2012, another outbreak of coronavirus AP occurred in the Middle East. Confusing case definitions such as MERS (Middle East respiratory syndrome) and SARI (severe acute respiratory infections) were coined. This paper aims to present a case of MP with sars, ARDS, pneumonia and pleural effusion during the MERS epidemics, and review the incidence and mortality of severe AP with MP. ⋯ We urge health organizations to refrain from the temptation of coining unnecessary new terminology to describe essentially the same conditions each and every time when outbreaks of AP occur.
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Autoimmune responses mediated by cluster of differentiation 4(+) T cells may contribute to the development of chronic obstructive pulmonary disease (COPD). However, little is known about the frequency of peripheral blood Th17 cells and of regulatory T cells (Tregs) in Chinese patients with COPD. This study is aimed at determining the frequency of circulating Th17 and Tregs in patients with moderate and severe COPD, heavy smokers and healthy controls (HC). ⋯ An imbalance of circulating Th17 cells and Tregs is associated with the deterioration of pulmonary function in patients with moderate and severe COPD.
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This is a sporadic H7N9 avian influenza case that was the first severe imported case in Beijing and the first case of Hebei province in China. A 61-year-old female who had rapidly progressive pneumonia with respiratory distress and bilateral exduation and consolidation changes on chest X-ray and computerized tomography (CT) scan that did not respond to ordinary antibiotics was diagnosed with influenza A (H7N9) infection in our hospital on July 19, 2013. Intravenous peramivir, veno-venous extracorporeal membrane oxygenation (VV-ECMO) and continuous veno-venous hemofiltration were given on the same day of lab diagnosis because of severe acute respiratory distress syndrome and acute renal failure. ⋯ Twenty-three days after hospitalization, blood stream infection with multidrug-resistant Acinetobacter Baumannii occurred, which lead to septic shock and death. Whether or not the influenza season in north China, the influenza screening should be carried out as a conventional test for the patients who are suspected of viral pneumonia. For the patients who need mechanical ventilation and ECMO support, the lung protective strategy under the guidance of transpulmonary pressure may be helpful for recovering the lung.