rome and Hypoxia

One of the aims of necropsy at neonatal and infantile ages is to identify the causes of death in this population, which is decreasing continuously because of the decay in natality seen in Italy as well as in other western countries over the last few decades. Analysis of 2410 autopsies performed on 92% of deaths in infants under one year of age occurring at the Bambino Gesù Hospital in Rome in 1974-89 shows a striking change in the principal causes of death in recent decades: Malformations, neonatal anoxia and immaturity have now become the main causes of death in the first year of life, while there is a very low rate of nutritional and infectious diseases, which predominated in the past. The autopsy results obtained indicate, however, that the policy of paediatric care in public health systems must be changed.

Topics: Autopsy; Cause of Death; Congenital Abnormalities; Fetal Death; Heart Defects, Congenital; Humans; Hypoxia; Infant; Infant Mortality; Infant, Newborn; Rome

Chronic obstructive pulmonary (COPD) is one of the major causes of morbidity and mortality in the world. COPD is characterized by chronic inflammation in the pulmonary compartment and in the systemic circulation. This disorder is associated with clinically significant alterations in biochemistry and organ function; thyroid dysfunctions are common in chronic diseases, such as COPD. Several characteristics of COPD patients could increase their likelihood of developing hypothyroidism or hyperthyroidism. The purpose of our study was to assess the impact of thyroid dysfunction in patients with COPD.. We evaluated the pulmonary function tests, arterial blood gases, maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), and thyroid functions in patients with COPD, recruited between admissions in Respiratory Diseases Unit, Policlinico Umberto I, Rome, Italy, from June 2012 to May 2013. We selected patients with subclinical hypothyroidism (ScH), overt hypothyroidism, and hyperthyroidism, and a control group without thyroid disturbance.. Our results indicate that patients with overt hypothyroidism have lower levels of pO2, MIP, and MEP compared with subjects with ScH, hyperthyroidism, and the control group. We also found a substantial tendency towards pCO2 levels increase in patients with hypothyroidism (p = 0.06).. Patients with thyroid dysfunctions have a greater impairment of MIP and MEP and a negative correlation was observed between hypoxemia and TSH. Further studies are needed to investigate whether the treatment of thyroid disfunction could have a beneficial effect on COPD patients' lung function and prognosis.

Topics: Aged; Aged, 80 and over; Biomarkers; Case-Control Studies; Female; Humans; Hyperthyroidism; Hypothyroidism; Hypoxia; Lung; Male; Middle Aged; Muscle Strength; Predictive Value of Tests; Pulmonary Disease, Chronic Obstructive; Respiratory Function Tests; Respiratory Muscles; Rome; Thyroid Function Tests; Thyroid Gland; Thyroid Hormones

Non-invasive positive pressure support ventilation (NIPSV).. In patients with acute hypoxaemic (PaO2/FiO2 &Mac178;100) non hypercapnic respiratory failure (ARF) admitted to a Respiratory Inter-mediate Intensive Care Unit of a general Hospital, between January 1993 and December 1997.. In 21 selected patients (PaO2/ FiO2T0=82+/-9) NIPSV improved PaO2 in 13/21 patients (Group A) and did not improve in 8/21 patients (Group B) (PaO2/FiO2T1=154+/-25 in Group A vs PaO2/FiO2T1=106+/-7.5 in Group B, p=0.00001). Upon admission the two groups did neither significantly differ for blood gas values (PaO2/FiO2T0=84+/-9.6 in Group A vs 79.8+/-8.7 in Group B), nor for clinical status (APACHE II=19.8+/-5 in Group A vs 24.6+/-7 in Group B). Shorter duration of NIPSV in Group B patients (11.2+/-19.7 hrs vs 35.3+/-32.3 hrs in Group A, p=0.047), in spite of a rise in PEEP (9.3+/-2.3 in Group B vs 5.5+/-2.4 in Group A, p=0.003) and Pressure Support (18.7+/-1.8 in Group B vs 15+/-3.2 in Group A, p=0.004) was due to onset of conditions which required shifting from NIPSV to endotracheal intubation (ETI).. 8/21 patients were successfully treated by only NIPSV. 8/21 patients were intubated. 5/21 patients dead in RIICU; 1 month survival: 9/21 patients. Side effects: mask intolerance (3/21); skin necrosis (1/21); pneumothorax (1/21).. NIPSV may be tried in ARF patients to improve PaO2 and avoid ETI.

Topics: Acute Disease; Adult; AIDS-Related Opportunistic Infections; Carbon Dioxide; Critical Care; Hospitals, General; Humans; Hypoxia; Intensive Care Units; Masks; Middle Aged; Oxygen; Pneumonia, Pneumocystis; Positive-Pressure Respiration; Postoperative Complications; Pulmonary Edema; Respiratory Distress Syndrome; Respiratory Insufficiency; Retrospective Studies; Rome; Sepsis; Shock, Cardiogenic; Survival Analysis; Treatment Outcome

Topics: Exercise; Humans; Hypoxia; Muscle, Skeletal; Muscular Diseases; Nutritional Status; Research; Respiratory Tract Diseases; Rome