Direct hemoperfusion with a polymyxin B-immobilized fiber column (PMX-DHP) was recently identified as an effective
treatment for sepsis-associated acute respiratory distress syndrome. However, little is known about the effectiveness of PMX-DHP for rapidly progressive IP. Objectives: The present study investigates whether PMX-DHP is safe and effective against rapidly progressive IP. Methods: We retrospectively examined the effects of PMX-DHP in 33 consecutive patients with rapidly progressive IP who were resistant to steroid pulse therapy. Patients were hospitalized at Nagasaki University Hospital between 2006 and 2009. Results: Seventy-two hours after PMX-DHP, the arterial oxygen tension/inspiratory oxygen fraction ratio (median 127-153 mm Hg) had significantly improved. One week after PMX-DHP, the arterial oxygen tension/inspiratory oxygen fraction ratio (median 127-227 mm Hg), the alveolar-arterial difference of oxygen (median 371-177 learn more Nepicastat in vitro mm Hg) and the number of positive criteria for systemic inflammatory response syndrome had significantly improved, despite the ineffectiveness of corticosteroid pulse therapy. The serum level of monocyte chemotactic protein 1 was significantly decreased immediately after PMX-DHP. Conclusions: PMX-DHP was safe and effective in improving
oxygenation and systemic inflammatory response syndrome in patients with rapidly progressive IP. The beneficial effects of PMX-DHP may be at least partially due to the inhibition of monocyte activation. Copyright ACY-241 (C) 2010 S. Karger AG, Basel”
“Background: Foreign body ingestion is a common problem among paediatric populations. A variety of foreign bodies are ingested, some of which are particularly harmful and life threatening
such as button batteries, magnets and bones. Common household items such as small toys, marbles, batteries and erasers are often ingested. The aim of this systematic review is to study the problem of foreign body ingestion among paediatric populations in terms of commonly ingested objects, and attempt to identify the link between location of impaction, associated symptoms, complications, spontaneous passage, methods and timing of removal.
Methods: A literature search of multiple databases including PubMed, Embase, Current Contents Connect and Medline were conducted for studies on foreign body ingestions. Based on strict inclusion and exclusion criteria, 17 studies were selected. A qualitative review of these studies was then performed to identify commonly ingested foreign bodies, symptoms, signs and complications of foreign body ingestion, rates of spontaneous passage and methods of retrieval of the ingested objects.
Results: Coins are the most commonly ingested foreign body. A variety of gastrointestinal symptoms such vomiting and drooling as well as respiratoty symptoms such as coughing and stridor are associated with foreign body ingestion.