scholarly journals Early corticosteroid treatment for postoperative acute lung injury after lung cancer surgery

2019 ◽  
Vol 13 ◽  
pp. 175346661984025 ◽  
Author(s):  
Hayoung Choi ◽  
Beomsu Shin ◽  
Hongseok Yoo ◽  
Gee Young Suh ◽  
Jong Ho Cho ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Acute Lung Injury ◽  
Treatment Group ◽  
Lung Injury ◽  
Early Treatment ◽  
Lung Resection ◽  
Lung Cancer Surgery ◽  
Corticosteroid Treatment ◽  
Early Treatment Group ◽  
Late Treatment

Background: Acute lung injury (ALI) is the most serious pulmonary complication after lung resection. Although the beneficial effects of low-dose corticosteroids have been demonstrated in patients with postoperative ALI, there are limited data on optimal corticosteroid treatment. Methods: We retrospectively analyzed 58 patients who were diagnosed with ALI among 7593 patients who underwent lung cancer surgery between January 2009 and December 2016. Results: Of the 58 patients, 42 (72%) received corticosteroid treatment within 72 h (early treatment group) and 16 (28%) received corticosteroid treatment more than 72 h after ALI occurred (late treatment group). The early treatment group demonstrated a higher response to corticosteroid treatment compared with the late treatment group (95% versus 69%, respectively, p = 0.014), had an improved lung injury score (86% versus 63%, p = 0.072), and were more likely to be successfully weaned from the ventilator within 7 days (57% versus 39%, p = 0.332). During corticosteroid treatment, the early treatment group had a lower rate of delirium (24% versus 63%, p = 0.012) compared with the late treatment group. No significant differences in length of stay (30 versus 37 days, p = 0.254) or in-hospital mortality (43% versus 38%, p = 0.773) were observed; however, the early treatment group tended to have a higher rate of successful weaning than the late treatment group ( p = 0.098, log-rank test). Conclusions: Early initiation of corticosteroid treatment improved lung injury and promoted ventilator weaning in patients with ALI following lung resection for lung cancer.

scholarly journals Sorafenib Inhibits Tumor Growth and Improves Survival in a Transgenic Mouse Model of Pancreatic Islet Cell Tumors

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Volker Fendrich ◽  
Katja Maschuw ◽  
Johannes Rehm ◽  
Malte Buchholz ◽  
Julia P. Holler ◽  
...  
Keyword(s):  
Cell Proliferation ◽  
Treatment Group ◽  
Tumor Progression ◽  
Early Treatment ◽  
Islet Cell ◽  
Control Group ◽  
Islet Cell Tumors ◽  
Pancreatic Islet Cell ◽  
Early Treatment Group ◽  
Late Treatment

Background. The purpose of the study was to evaluate Sorafenib (BAY 43-9006) derived receptor tyrosine kinase inhibition on tumor progression in murine islet cell tumors. Sorafenib is considered to be a potent inhibitor of tumor angiogenesis and neovascularization in various solid tumors. Rip1Tag2 mice were treated in two different groups according to the model of tumor progression: the early treatment group received vehicle or Sorafenib from 10 to 14 weeks of age and the late treatment group from week 12 until death. Tumor surface, tumor cell proliferation, and apoptosis were measured in both treatment groups to assess the in vivo effects of Sorafenib. Survival was recorded for the late treatment group. In the early treatment group Sorafenib led to a dramatic decrease in tumor volume compared to the control group. Apoptosis was significantly augmented and cell proliferation was inhibited. As a single therapy Sorafenib significantly improved survival in the late treatment group.Conclusion. Sorafenib may provide a new paradigm for the therapy of islet cell tumors.

Early Treatment of a Migraine Attack while Pain is Still Mild Increases the Efficacy of Sumatriptan

Cephalalgia ◽  
2004 ◽  
Vol 24 (11) ◽  
pp. 925-933 ◽  
Author(s):  
J Scholpp ◽  
R Schellenberg ◽  
B Moeckesch ◽  
N Banik
Keyword(s):  
Treatment Group ◽  
Migraine Attack ◽  
Early Treatment ◽  
International Headache Society ◽  
Open Label ◽  
Open Label Study ◽  
Label Study ◽  
Delayed Treatment ◽  
Early Treatment Group ◽  
Late Treatment

To investigate the hypothesis that early treatment of a migraine attack with sumatriptan, while pain is still mild, results in higher pain free rates in comparison to delayed treatment, when pain is at least moderate, we performed a prospective, controlled and open label study. Migraineurs with or without aura who fulfilled the diagnostic criteria recommended by the International Headache Society were enrolled in the study and randomly assigned to either ‘early’ or ‘late’ treatment with sumatriptan 100 mg tablets. In the early treatment group significantly more patients were pain free at all times measured during two hours after dosing than in the late treatment group. Furthermore, patients in the early treatment group became pain free significantly sooner after dosing than patients who delayed treatment. It is concluded that migraineurs, who are able to differentiate between a migraine attack and other forms of headache, benefit from early intervention with sumatriptan 100 mg tablets.

scholarly journals Delayed Initiation of Supplemental Pain Management is Associated with Postherpetic Neuralgia: A Retrospective Study

2020 ◽  
Vol 1;23 (1;1) ◽  
pp. 65-72
Author(s):  
Min Yan
Keyword(s):  
Retrospective Study ◽  
Pain Management ◽  
Treatment Group ◽  
Postherpetic Neuralgia ◽  
Early Treatment ◽  
Initial Time ◽  
Early Treatment Group ◽  
Delayed Initiation ◽  
Late Treatment ◽  
Risk Patients

Background: Acute pain is a risk factor for developing postherpetic neuralgia (PHN), the most common complication of herpes zoster (HZ). Supplemental analgesics are frequently used in the treatment of acute herpetic pain. However, there are insufficient data regarding when to begin supplemental analgesics, and it is unknown whether the delayed use of supplemental analgesics increases the risk of PHN in high-risk patients. Objectives: This study aimed to evaluate the association between initial time of supplemental pain management and the risk of PHN in high-risk patients. Study Design: Retrospective study. Setting: The Department of Anesthesiology and Pain Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine. Methods: We performed a retrospective study between May 13, 2017 and August 8, 2018 in our clinic. Multivariable logistic regression analysis was conducted to examine the independent factors associated with PHN. Supplemental pain management was defined as any use of opioids, tricyclic antidepressants, or nerve blocks. A subgroup analysis was conducted in patients who received supplemental pain management within the first 30 days of onset. According to the initial time of supplemental pain management, patients were divided into 2 groups: the early treatment group (≤ 14 days), and the late treatment group (> 14 days). The clinical outcomes in these 2 groups was compared for propensity score (PS) matching. Results: A total of 134 patients with HZ aged 50 years or older with moderate to severe pain were enrolled in this study. The delayed initiation of supplemental pain management (> 14 days) (odds ratio, 4.11; 95% confidence interval, 1.69-9.92; P = 0.002) and severity of rash (odds ratio, 2.93; 95% confidence interval, 1.22-7.01; P = 0.016) were independent factors associated with PHN. In the subgroup analysis, after PS matching, there were no significant differences in the baseline clinical parameters between the early and late treatment groups. The incidence of PHN was significantly lower in the early treatment group than the late treatment group (36. 4% vs. 72.7%; P = 0.015). Reduction in pain was also greater in the early treatment group. Limitations: The findings identified in the present study are specific to the patients who were relatively older and with moderate to severe pain. It is impossible to determine from our study whether younger individuals and individuals with mild acute pain will benefit from early supplemental treatments. Furthermore, because of the retrospective nature of the study, there may be some confounders that could not be controlled. Further prospective studies with larger sample sizes and longer follow-up periods are needed. Conclusions: The early use of supplemental pain management may decrease the risk of PHN. It might therefore be beneficial to consider administering supplemental pain management earlier in older patients with moderate to severe acute herpetic pain. Key words: Herpes zoster, postherpetic neuralgia, analgesia, opioid, nerve block, tricyclic antidepressant

scholarly journals Hemosorption by a Column Adsorber Based on Hyper-Cross-Linked Styrene-Divinylbenzene Copolymer with Immobilized Lipopolysaccharide-Selective Ligand in Combined Intensive Care of Lung Cancer-Related Postoperative Acute Lung Injury (Case Report)

2020 ◽  
Vol 16 (4) ◽  
pp. 14-20
Author(s):  
N. D. Ushakova ◽  
S. N. Tikhonova ◽  
D. A. Rozenko
Keyword(s):  
Lung Cancer ◽  
Acute Lung Injury ◽  
Lung Injury ◽  
Critically Ill ◽  
Combined Therapy ◽  
Lung Cancer Surgery ◽  
Pulmonary Epithelium ◽  
Selective Sorption ◽  
Selective Ligand ◽  
Styrene Divinylbenzene

Acute respiratory distress syndrome (ARDS) is a serious challenge in the contemporary reanimatology due to its prevalence, versatility of pathogenesis mechanisms, and continuously high mortality. The development of an uncontrolled cascade of systemic inflammation reactions, ‘cytokine storm’, followed by multiple organ failure (MOF) is an essential pathophysiological trigger of acute lung injury. Besides, critically ill patients are characterized by a relative intestinal ischemia, wherein, according to the ‘intestine-lung axis’ concept that treats intestinal and pulmonary epithelium as a continuous surface, translocation of bacteria and/or endotoxin directly into blood flow might occur. Extracorporeal removal of excessively produced inflammatory response mediators and endotoxin (bacterial lipopolysaccharide, LPS) from systemic circulation by selective hemosorption might represent a life-saving approach in sepsis.Purpose: to evaluate the efficacy of selective sorption in a combined therapy for acute lung injury related to postoperative injury after lung cancer surgery.Results. A single 4-hour selective sorption procedure in the combined therapy of a critically ill postoperative patient produced fast (within 24 hrs.) effects: decreased leukocytosis (the leukocyte count fell down from 32X109 to 13X109, L-1) and endotoxin activity (EAA — from 0.67 to 0.32, units), reduced blood plasma anti-inflammatory cytokine (IL-6 — from 1860 to 62, pg/ml) and procalcitonin (PCT — from 46 to 0.32, ng/ml), recovery of gas exchange, discontinuation of hemodynamic support with pressor amines as no longer needed (as early as 2 hours after sorption).Conclusion. The clinical case of a successful therapy including selective sorption based on hyper-crosslinked styrene-divinylbenzene copolymer with immobilized LPS-selective ligand warrants further clinical studies on the efficiency of a novel selective hemosorption column use to correct post-radical respiratory complications in oncological patients.

46 Impact of early versus late medical treatment of a hemodynamically significant patent ductus arteriosus on time to reach full feeds in preterm neonates

2021 ◽  
Vol 26 (Supplement_1) ◽  
pp. e32-e34
Author(s):  
Krishan Yadav ◽  
Joseph Ting ◽  
Michael Castaldo ◽  
Gurpreet Grewal ◽  
Mimi Kuan
Keyword(s):  
Treatment Group ◽  
Patent Ductus Arteriosus ◽  
Medical Treatment ◽  
Preterm Infants ◽  
Early Treatment ◽  
Prolonged Exposure ◽  
Ductus Arteriosus ◽  
Early Treatment Group ◽  
Late Treatment ◽  
Patent Ductus

Abstract Primary Subject area Neonatal-Perinatal Medicine Background Prolonged exposure to a hemodynamically significant patent ductus arteriosus (hsPDA) in preterm infants has been associated with an increase in neonatal morbidities. Objectives To examine the effect of timing of medical treatment (within first 7 days of life versus after 7 days of life) for a hsPDA on the duration to achieve full feeds in infants born at <30 weeks of gestation. Design/Methods This was a retrospective cohort study in a quaternary neonatal intensive care unit (NICU) with a targeted neonatal echocardiography service. Infants admitted between July 2015 – June 2019 who received medical treatment for an hsPDA were included and grouped based on those who received first medical therapy within 7 days of life (early treatment) and after 7 days of life (late treatment). An hsPDA was defined using both clinical (worsening ventilation, pulmonary hemorrhage/edema, or hypotension requiring inotrope or hydrocortisone) and echocardiographic findings (LA/Ao ratio >1.4; LVO >350 mL/kg/min, PDA >1.4 mm, IVRT < 35 ms). Duration to reach full feeds was calculated based on number of days to reach a total enteral feed ≥ 120 mL/kg/day with no parenteral source of nutrition. Results Forty-six infants met the inclusion criteria. Of the 46 infants, 24 were identified as receiving early treatment and 22 received late treatment. Infants in the early treatment group had lower median birth weight than the late treatment group (802 g vs. 1016 g, p=0.022). All other clinical characteristics were not significantly different. No significant difference was found in the use of indomethacin, ibuprofen, or acetaminophen as the initial medical treatment (Table 1). The late treatment group had elevated left ventricular output (median: 286 vs. 369 mL/kg/min, p=0.013) and tricuspid annular plane systolic excursion (median: 6 vs. 8 mm, p=0.002) (Table 2). Infants in the early treatment group reached full feeds earlier than those in the late treatment group (19 vs. 30 days, p=0.042) (Table 1). Conclusion Early medical treatment of hsPDA was associated with shorter duration to reach full feeds in our cohort of preterm infants. Further larger scale study is needed to understand the association between the timing of medical therapy and prolonged exposure of splanchnic circulation to hemodynamically significant ductus.

scholarly journals Angiotensin-Converting Enzyme 2 Activator Ameliorates Severe Pulmonary Hypertension in a Rat Model of Left Pneumonectomy Combined With VEGF Inhibition

2021 ◽  
Vol 8 ◽  
Author(s):  
I-Chen Chen ◽  
Jao-Yu Lin ◽  
Yi-Ching Liu ◽  
Chee-Yin Chai ◽  
Jwu-Lai Yeh ◽  
...  
Keyword(s):  
Treatment Group ◽  
Angiotensin Converting Enzyme ◽  
Early Treatment ◽  
Converting Enzyme ◽  
Angiotensin Converting Enzyme 2 ◽  
Early Treatment Group ◽  
Vehicle Treatment ◽  
Late Treatment ◽  
Vegf Inhibition ◽  
Left Pneumonectomy

Background: Pulmonary arterial hypertension (PAH) is a life-threatening and deteriorating disease with no promising therapy available currently due to its diversity and complexity. An imbalance between vasoconstriction and vasodilation has been proposed as the mechanism of PAH. Angiotensin-converting enzyme 2 (ACE2), which catalyzes the hydrolysis of the vasoconstrictor angiotensin (Ang) II into the vasodilator Ang-(1-7), has been shown to be an important regulator of blood pressure and cardiovascular diseases. Herein we hypothesized diminazene aceturate (DIZE), an ACE2 activator, could ameliorate the development of PAH and pulmonary vascular remodeling.Methods: A murine model of PAH was established using left pneumonectomy (PNx) on day 0 followed by injection of a single dose of the VEGF receptor-2 inhibitor SU5416 (25 mg/kg) subcutaneously on day 1. All hemodynamic and biochemical measurements were done at the end of the study on day 42. Animals were divided into 4 groups (n = 6–8/group): (1) sham-operated group, (2) vehicle-treatment group (SuPNx42), (3) early treatment group (SuPNx42/DIZE1−42) with DIZE at 15 mg/kg/day, subcutaneously from day 1 to day 42, and (4) late treatment group (SuPNx42/DIZE29−42) with DIZE from days 29–42.Results: In both the early and late treatment groups, DIZE significantly attenuated the mean pulmonary artery pressure, pulmonary arteriolar remodeling, and right ventricle brain natriuretic peptide (BNP), as well as reversed the overexpression of ACE while up-regulating the expression of Ang-(1-7) when compared with the vehicle-treatment group. In addition, the early treatment group also significantly decreased plasma BNP and increased the expression of eNOS.Conclusions: ACE2 activator has therapeutic potentials for preventing and attenuating the development of PAH in an animal model of left pneumonectomy combined with VEGF inhibition. Activation of ACE2 may thus be a useful therapeutic strategy for the treatment of human PAH.

scholarly journals Risk factors of postoperative acute lung injury following lobectomy for nonsmall cell lung cancer

Medicine ◽  
2019 ◽  
Vol 98 (13) ◽  
pp. e15078 ◽  
Author(s):  
Hyun Jung Kim ◽  
Seung Ick Cha ◽  
Chang-Ho Kim ◽  
Jaehee Lee ◽  
Joon Yong Cho ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lung Cancer ◽  
Acute Lung Injury ◽  
Lung Injury ◽  
Cell Lung Cancer ◽  
Nonsmall Cell Lung Cancer
Sign in / Sign up

Export Citation Format

Share Document