The Role of rescue therapies in the treatment of severe ARDS

ARDS is characterized by a non-cardiogenic pulmonary edema with bilateral chest radiograph opacities and hypoxemia refractory to oxygen therapy. It is a common cause of admission to the ICU due to hypoxemic respiratory failure requiring mechanical ventilation. Corticosteroids are not recommended in ARDS patients. Rescue therapies alleviate hypoxemia in patients unable to maintain reasonable oxygenation: recruitment maneuvers, prone positioning, inhaled nitric oxide, high-frequency oscillatory ventilation, and extracorporeal membrane oxygenation improve oxygenation, but their impact on mortality remains unproven. Restrictive fluid management seems to be a favorable strategy with no significant reduction in 60-d mortality. Future studies are needed to clarify the efficacy of these therapies on outcomes in patients with severe ARDS, and institution of these therapies may be considered on a case-by-case basis

Charm nonleptonic decays and final state interactions

A global previous analysis of two-body nonleptonic decays of $D$ mesons has been extended to the decays involving light scalar mesons. The allowance for final state interaction also in nonresonant channels provides a fit of much improved quality and with less symmetry breaking in the axial charges. We give predictions for about 50 decay branching ratios yet to be measured. We also discuss long distance contributions to the difference $\Delta \Gamma$ between the $D_S$ and $D_L$ widths.Comment: 14 pages, no figures, plain TeX, uses harvmac.tex and tables.te

Case report. A rare case of giant basal cell carcinoma and malignant melanoma

The presence of two several skin lesions in the same patient is a rare occurrence in dermatological findings. The associations of malignant melanoma (MM) and giant basal cell carcinoma (BCC) within the same patient have only been described in few cases in the literature.1,6 Is there a common genetic origin? However, until now the pathogenesis of collision tumors existing of MM and BCC remains unclear. We, therefore, report a case of association of MM and BCC in the same patient

The course of cancer related fatigue up to ten years in early breast cancer patients. What impact in clinical practice?

Little is known about the cancer related fatigue (CRF) along cancer course and risk factors that could predict CRF development and persistence in breast cancer (BC) survivors. This prospective study detected incidence, timing of onset, duration of CRF, impact on QoL and psychological distress. Seventy-eight early BC patients, undergoing chemotherapy (CT) followed or not by hormonal therapy were assessed for QoL and psychological distress by EORTC QLQC30 and HADs questionnaires. Fatigue was investigated with mix methods, structured interview and psychometric measures. A qualitative analysis was added to assess the behavioral pattern of CRF. Low fatigue levels were identified after surgery (9%), increasing during (49%) and at the end of CT (47%), maintaining after 1 year (31%) and declining up to ten years of follow-up. Prevalence of CRF was higher at the end of CT and lower at follow-up. At the end and after 1 and 2 years from CT, persistence of CRF was associated to anxiety in 20%, 11% and 5% and to depression in 15%, 10% and 5% respectively. A relationship between CRF and psychological distress was observed; patients presenting depression and anxiety before CT were at higher risk for fatigue onset at a later period. A relationship between fatigue and QoL was noted at the end of CT. Our study shows the fatigue timely trend in early BC patients from surgery, CT and follow-up. Identification of biological, psychological, social predictor factors related to fatigue could be helpful for early interventions in patients at higher risk of developing fatigue

A rare case of leiomyoma of the bladder

Bladder leiomyoma is a benign tumour of the bladder and constitute <0.5% of all bladder tumors. We report a clinical case of a 51‑year‑old female who presented with with symptomatic bladder leiomyoma. An ultrasound examination showed well-defined bladder leiomyoma in the right posterior bladder wall, which was excised through a transurethral resection. The pathologic diagnosis was bladder leiomyoma

Mechanical ventilation and long-term neurocognitive impairment after acute respiratory distress syndrome

We read with great attention and interest the paper by Sasannejad et al. on long-term cognitive impairment after acute respiratory distress syndrome (ARDS) [1]. In this comprehensive review, the authors report data that widely range from epidemiology and pathophysiology to possible therapies, from hypoxemia and delirium to mechanical ventilation (MV)

Perioperative neurocognitive disorder. Comment

We read with great interest the review article by Eckenhoff et al. on the different approaches used in preclinical perioperative neurocognitive disorder research.1 In this review, the authors provided data on the various preclinical models used in scientific literature to study perioperative neurocognitive disorder that include molecular, cell culture, brain slices, and animal models. Surprisingly, the possible role of mechanical ventilation as cause of perioperative neurocognitive disorder is not mentioned