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101. MANIOBRAS DE RECLUTAMIENTO ALVEOLAR

Author

Cristancho, William, Aurio Fajardo, Medina, Alberto, Rocha, Ângelo Roncalli Miranda, Alapont, Vicente Modesto I, Monares, Enrique, Adasme, Rodrigo, Ferrando, Carlos, Perez, Juan Carlos, and Paziencia, Fernando

Published
2020
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105. Agaricus subrufescens and Pleurotus ostreatus mushrooms as alternative additives to antibiotics in diets for broilers challenged with Eimeria spp.

Author

Lima, G. A., primary, Barbosa, B. F. S., additional, Araujo, R. G. A. C., additional, Polidoro, B. R., additional, Polycarpo, G. V., additional, Zied, D. C., additional, Biller, J. D., additional, Ventura, G., additional, Modesto, I. M., additional, Madeira, A. M. B. N., additional, and Cruz-Polycarpo, V. C., additional

Published
2020
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113. P598 Incidence of venous thromboembolic events in patients with ulcerative colitis treated with tofacitinib in the ulcerative colitis clinical development programme: An update as of May 2019

Author

Sandborn MD, W J, primary, Panés, J, additional, Sands, B E, additional, Reinisch, W, additional, Modesto, I, additional, Su, C, additional, Steinwurz, F, additional, Lawendy, N, additional, Koram, N, additional, Kwok, K, additional, Jones, T V, additional, Thorpe, A J, additional, Quirk, D, additional, and Danese, S, additional

Published
2020
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118. Bayes to the Rescue

Author

Pablo del Villar Guerra, Alfred Molina Cambra, Alberto Medina, Robinder G. Khemani, and Vicent Modesto i Alapont

Subjects
Male, medicine.medical_treatment, Treatment outcome, Population, 030204 cardiovascular system & hematology, Critical Care and Intensive Care Medicine, medicine.disease_cause, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Humans, Medicine, 030212 general & internal medicine, Continuous positive airway pressure, education, Randomized Controlled Trials as Topic, education.field_of_study, Continuous Positive Airway Pressure, business.industry, Infant, Newborn, Oxygen Inhalation Therapy, Infant, Data interpretation, Bayes Theorem, High flow oxygen, Pneumonia, respiratory system, Treatment Outcome, Child, Preschool, Data Interpretation, Statistical, Anesthesia, Pediatrics, Perinatology and Child Health, Female, business, Monte Carlo Method, Lower mortality, Nasal cannula
Abstract

Objectives The merits of high-flow nasal cannula oxygen versus bubble continuous positive airway pressure are debated in children with pneumonia, with suggestions that randomized controlled trials are needed. In light of a previous randomized controlled trial showing a trend for lower mortality with bubble continuous positive airway pressure, we sought to determine the probability that a new randomized controlled trial would find high-flow nasal cannula oxygen superior to bubble continuous positive airway pressure through a "robust" Bayesian analysis. Desing, setting, patients, and interventions Sample data were extracted from the trial by Chisti et al, and requisite to "robust" Bayesian analysis, we specified three prior distributions to represent clinically meaningful assumptions. These priors (reference, pessimistic, and optimistic) were used to generate three scenarios to represent the range of possible hypotheses. 1) "Reference": we believe bubble continuous positive airway pressure and high-flow nasal cannula oxygen are equally effective with the same uninformative reference priors; 2) "Sceptic on high-flow nasal cannula oxygen": we believe that bubble continuous positive airway pressure is better than high-flow nasal cannula oxygen (bubble continuous positive airway pressure has an optimistic prior and high-flow nasal cannula oxygen has a pessimistic prior); and 3) "Enthusiastic on high-flow nasal cannula oxygen": we believe that high-flow nasal cannula oxygen is better than bubble continuous positive airway pressure (high-flow nasal cannula oxygen has an optimistic prior and bubble continuous positive airway pressure has a pessimistic prior). Finally, posterior empiric Bayesian distributions were obtained through 100,000 Markov Chain Monte Carlo simulations. Measurements and main results In all three scenarios, there was a high probability for more death from high-flow nasal cannula oxygen compared with bubble continuous positive airway pressure (reference, 0.98; sceptic on high-flow nasal cannula oxygen, 0.982; enthusiastic on high-flow nasal cannula oxygen, 0.742). The posterior 95% credible interval on the difference in mortality identified a future randomized controlled trial would be extremely unlikely to find a mortality benefit for high-flow nasal cannula oxygen over bubble continuous positive airway pressure, regardless of the scenario. Interpreting these findings using the "range of practical equivalence" framework would recommend rejecting the hypothesis that high-flow nasal cannula oxygen is superior to bubble continuous positive airway pressure for these children. Conclusions For children younger than 5 years with pneumonia, high-flow nasal cannula oxygen has higher mortality than bubble continuous positive airway pressure. A future randomized controlled trial in this population is unlikely to find high-flow nasal cannula oxygen superior to bubble continuous positive airway pressure.

Published
2017
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120. HIGH-FLOW THERAPY FOR BRONCHIOLITIS

Author

Vicent Modesto i Alapont, Alberto Medina, Pablo del Villar-Guerra, and Miriam Gutiérrez

Subjects
medicine.medical_specialty, business.industry, Oxygen Inhalation Therapy, Infant, medicine.disease, Text mining, Bronchiolitis, Pediatrics, Perinatology and Child Health, medicine, Humans, Intensive care medicine, business, High flow, Child, Emergency Service, Hospital
Published
2019

121. High-Flow Nasal Cannula Versus Noninvasive Ventilation: A Matter of Confusion

Author

Vicent Modesto I Alapont, Martí Pons-Òdena, and Alberto Medina

Subjects
business.industry, Critical Care and Intensive Care Medicine, medicine.disease, medicine.disease_cause, Cannula, Bronchiolitis, Anesthesia, Pediatrics, Perinatology and Child Health, medicine, Noninvasive ventilation, medicine.symptom, Positive-Pressure Respiration, business, High flow, Nasal cannula, Confusion
Published
2019

123. CPAP support should be considered as the first choice in severe bronchiolitis

Author

Vicent Modesto i Alapont, Pablo del Villar-Guerra, and Alberto Medina

Subjects
medicine.medical_specialty, Continuous Positive Airway Pressure, business.industry, 030204 cardiovascular system & hematology, medicine.disease, 03 medical and health sciences, 0302 clinical medicine, Bronchiolitis, Pediatrics, Perinatology and Child Health, medicine, Humans, 030212 general & internal medicine, Intensive care medicine, business
Published
2019

126. PALICC definition of ARDS. Don’t remove that brick from the wall and keep it smart and simple

Author

P. del Villar-Guerra, V. Modesto i Alapont, and A. Medina

Subjects
Brick, Adolescent, business.industry, Infant, 030208 emergency & critical care medicine, Structural engineering, Critical Care and Intensive Care Medicine, Respiratory Function Tests, 03 medical and health sciences, 0302 clinical medicine, 030228 respiratory system, Spain, Child, Preschool, Terminology as Topic, Acute Disease, Humans, Medicine, 030212 general & internal medicine, Age of Onset, Child, Respiratory Insufficiency, business, Lung, Humanities, Simple (philosophy)
Published
2016
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130. Paediatric acute respiratory distress syndrome incidence and epidemiology (PARDIE): an international, observational study

Author

Robinder G Khemani, Lincoln Smith, Yolanda M Lopez-Fernandez, Jeni Kwok, Rica Morzov, Margaret J Klein, Nadir Yehya, Douglas Willson, Martin C J Kneyber, Jon Lillie, Analia Fernandez, Christopher J L Newth, Philippe Jouvet, Neal J Thomas, Eugenia Abaleke, Kate G Ackerman, Carlos Acuña, Michelle Adu-Darko, Jeremy T Affolter, Rachel Agbeko, Ahmed Al Amoudi, Ahmad Alahmadti, Nedaa Aldairi, Omar Alibrahim, Kiona Allen, Christine Allen, Awni Al-Subu, María Althabe, Jimena Alvear, Ayse Berna Anil, Heather Anthony, Angela Aramburo, David Arjona Villanueva, Neda Ashtari, Antonio Ávila Vera, Paul Baines, Melissa Bales, Samantha Barr, Dana Barry, Florent Baudin, John Beca, Holly Belfield, Fernando Beltramo, Laura Benken, Anoopindar Bhalla, Andrea Blom, Priscila Botta, Pierre Bourgoin, Marta Brezmes, George Briassoulis, Armelle Bridier, Joe Brierley, Sonia Brio Sanagustin, Elizabeth Broden, Warwick Butt, Kris Bysani, Cristina Camilo, Anna Camporesi, Santiago Campos-Miño, Fulya Kamit Can, Patricia Capocasa, Daniel Caro I, Christopher Carroll, Pablo Castellani, Andres E. Castillo, Yang Chen, Ranjit S. Chima, Fabrizio Chiusolo, Karina Cinquegrani, Bria Coates, Alvaro Coronado-Munoz, Ambar Cortéz, Pablo Cruces Romero, Melissa Cullimore, Natalie Cvijanovich, Mary K. Dahmer, Akash Deep, Carmel Delzoppo, Matteo Di Nardo, Franco Díaz, Sandra Dijkstra, W. Keith Dockery, Troy E. Dominguez, Mariana Dumitrascu, Oguz Dursun, Buvana Dwarakanathan, Ismail Elghuwael, Guillaume Emeriaud, Simon Erickson, Segundo Fernando Español, Jim Brian Estil, Calandra Feather, Yael Feinstein, Analía Fernández, Marcela Ferreyra, Heidi Flori, Yanina Vanesa Fortini, Peter-Marc Fortune, Mary Ellen French, Mirella Gaboli, Helen Gale, Paula García Casas, Maria García González, Richa Gautam, Rainer Gedeit, Mathieu Genuini, Shira Gertz, Martin Giampieri, Carlos Gil Escobar, John S. Giuliano Jr, Loreto Godoy Mundaca, Concepción Goni Orayen, Jose Manuel Gonzalez Gomez, Beatriz Govantes, Julie Guichoux, Gustavo Alfredo Guzman Rivera, Bereketeab Haileselassie, Yong Y Han, Amy Harrell, Silvia Hartmann, Tarek Hazwani, Glenda Hefley, Grace Henderson, Deyin D. Hsing, Amber Hughes-Schalk, Janet Hume, Stavroula Ilia, David Inwald, Thomas Iolster, Ledys María Izquierdo, Shirin Jafari-Namin, Nancy Jaimon, Alberto E Jarillo Quijada, J. Dean Jarvis, Chaandini Jayachandran, Claire Jennings, Asumthia S. Jeyapalan, Nestor Javier Jimenez Rivera, Dawn Jones, Mary Kasch, Jane't Keary, Connor Kelley, Aaron Kessel, Robinder Khemani, Yoshiko Kida, Caroline King, Martin Kneyber, Allison Kniola, Kelli Krallman, Sherri Kubis, Lucinda Kustka, Michihito Kyo, Luis Martín Landry, Samir Latifi, Angela Lawton-Woodhall, John C. Lin, Ana M. Llorente de la Fuente, Yurika Paola Lopez Alarcón, Yolanda López Fernández, Jesús Lopez-Herce, Lucy Chai See Lum, Duncan Macrae, Aline B. Maddux, Paula Madurga Revilla, Sidharth Mahapatra, Matthieu Maria, Lidia Martínez, Amelia Martinez de Azagra, Alejandro Fabio Martínez León, Liliana Mazzillo Vega, Jenni McCorkell, Karen McIntyre, Tania Medina, Alberto Medina, Christie Mellish, Mikel Mendizabal, Courtney Merritt, Reinout Mildner, Christophe Milesi, Vicent Modesto I Alapont, Cecilia Monjes, Tracey Monjure, María José Montes, Antonio Morales Martinez, Ryan Morgan, Peter M. Mourani, Kathy Murkowski, Marie Murphy, Natalie Napolitano, Dan Nerheim, Sholeen T. Nett, Christopher Newth, Ryan Nofziger, Maria Jose Nunez, Shinichiro Ohshimo, Eider Onate Vergara, Ebru A Ongun, Daniel Orqueda, Siva Oruganti, Izabela Pagowska-Klimek, Daniel Palanca Arias, Jon Pappachan, Rosalba Pardo Carrero, Margaret M. Parker, Julio Parrilla, Nikhil Patankar, Paula Pávez Madrid, Valerie Payen, Fernando Paziencia, Claudia Pedraza, Germán Perez Lozano, Javier Pilar Orive, Byron Enrique Piñeres Olave, Alyssa Pintimalla, Neethi Pinto, Adrian Plunkett, Steve Pon, Marti Pons Odena, Rossana Poterala, Haiping Qiao, Deyanira Quiñonez Lopez, Kimberly Ralston, Grimaldo Ramirez Cortez, Anna Ratiu, Miriam Rea, Susana Reyes Dominguez, Chiara Rodgers, Patricia Rodriguez Campoy, Laurie Ronan, Deheza Rosemary, Courtney Rowan, Kalaimaran Sadasivam, Juan Ignacio Sanchez Diaz, Ron Sanders, James Santanelli, Anil Sapru, James Schneider, Jesica Sforza, Sara Shea, Steven L. Shein, Claire Sherring, Victoria Sheward, Nobuaki Shime, Avani Shukla, Alejandro Siaba Serrate, Yamila Sierra, Lindsay Sikora, Catarina Silvestre, Marcy Singleton, Daniel Sloniewsky, Rebecca Smith, Hanqiu Song, Marta Sousa Moniz, Michael Spaeder, Debbie Spear, Philip Spinella, Julie Starck, Erin Stoneman, Felice Su, Gayathri Subramanian, Erin Sullivan, Santosh Sundararajan, Todd Sweberg, Kim Sykes, Yuichi Tabata, Chian Wern Tai, Joana Tala, Swee Fong Tang, José Tantalean, Ryan Taylor, Neal Thomas, Shane Tibby, Kelly S Tieves, Luis Torero, Silvio Fabia Torres, Balagangadhar Totapally, Brendan Travert, Edward Truemper, Gonzalo Turón, Katri Typpo, Juan Ramón Valle, Sonia I Vargas G, Pablo Vasquez Hoyos, Daniel Vasquez Miranda, Martin Vavrina, Nilda Águeda Vidal, Manpreet Virk, Laura Walsh, Adriana Wegner Araya, James Weitz, Lawren Wellisch, Paul Wellman, Katherine Woods, Rocio Yerovi, Toni Yunger, Cesar Zuluaga Orrego, Jiri Zurek, and Critical care, Anesthesiology, Peri-operative and Emergency medicine (CAPE)

Subjects
Pulmonary and Respiratory Medicine, Male, medicine.medical_specialty, Internationality, Cross-sectional study, Acute Lung Injury, Kaplan-Meier Estimate, Lung injury, Intensive Care Units, Pediatric, Severity of Illness Index, 03 medical and health sciences, 0302 clinical medicine, Sex Factors, Anesthesiology, Cause of Death, Epidemiology, Severity of illness, Medicine, Humans, 030212 general & internal medicine, Hospital Mortality, Prospective Studies, Prospective cohort study, Child, Cause of death, Respiratory Distress Syndrome, business.industry, Incidence (epidemiology), Age Factors, Prognosis, Combined Modality Therapy, Survival Analysis, United States, Cross-Sectional Studies, 030228 respiratory system, Area Under Curve, Child, Preschool, Emergency medicine, Female, business
Abstract

Summary Background Paediatric acute respiratory distress syndrome (PARDS) is associated with high mortality in children, but until recently no paediatric-specific diagnostic criteria existed. The Pediatric Acute Lung Injury Consensus Conference (PALICC) definition was developed to overcome limitations of the Berlin definition, which was designed and validated for adults. We aimed to determine the incidence and outcomes of children who meet the PALICC definition of PARDS. Methods In this international, prospective, cross-sectional, observational study, 145 paediatric intensive care units (PICUs) from 27 countries were recruited, and over a continuous 5 day period across 10 weeks all patients were screened for enrolment. Patients were included if they had a new diagnosis of PARDS that met PALICC criteria during the study week. Exclusion criteria included meeting PARDS criteria more than 24 h before screening, cyanotic heart disease, active perinatal lung disease, and preparation or recovery from a cardiac intervention. Data were collected on the PICU characteristics, patient demographics, and elements of PARDS (ie, PARDS risk factors, hypoxaemia severity metrics, type of ventilation), comorbidities, chest imaging, arterial blood gas measurements, and pulse oximetry. The primary outcome was PICU mortality. Secondary outcomes included 90 day mortality, duration of invasive mechanical and non-invasive ventilation, and cause of death. Findings Between May 9, 2016, and June 16, 2017, during the 10 study weeks, 23 280 patients were admitted to participating PICUs, of whom 744 (3·2%) were identified as having PARDS. 95% (708 of 744) of patients had complete data for analysis, with 17% (121 of 708; 95% CI 14–20) mortality, whereas only 32% (230 of 708) of patients met Berlin criteria with 27% (61 of 230) mortality. Based on hypoxaemia severity at PARDS diagnosis, mortality was similar among those who were non-invasively ventilated and with mild or moderate PARDS (10–15%), but higher for those with severe PARDS (33% [54 of 165; 95% CI 26–41]). 50% (80 of 160) of non-invasively ventilated patients with PARDS were subsequently intubated, with 25% (20 of 80; 95% CI 16–36) mortality. By use of PALICC PARDS definition, severity of PARDS at 6 h after initial diagnosis (area under the curve [AUC] 0·69, 95% CI 0·62–0·76) discriminates PICU mortality better than severity at PARDS diagnosis (AUC 0·64, 0·58–0·71), and outperforms Berlin severity groups at 6 h (0·64, 0·58–0·70; p=0·01). Interpretation The PALICC definition identified more children as having PARDS than the Berlin definition, and PALICC PARDS severity groupings improved the stratification of mortality risk, particularly when applied 6 h after PARDS diagnosis. The PALICC PARDS framework should be considered for use in future epidemiological and therapeutic research among children with PARDS. Funding University of Southern California Clinical Translational Science Institute, Sainte Justine Children's Hospital, University of Montreal, Canada, Reseau en Sante Respiratoire du Fonds de Recherche Quebec-Sante, and Children's Hospital Los Angeles, Department of Anesthesiology and Critical Care Medicine.

Published
2018

132. Seguridad de la aerosolterapia durante la ventilación mecánica no invasiva con helmet y mascarilla facial total en población pediátrica

Author

V. Modesto i Alapont, Corsino Rey, M.L. Palacios Loro, L. Rodriguez Garcia, Ana Vivanco-Allende, Juan Mayordomo-Colunga, and A. Medina

Subjects
medicine.medical_specialty, Time Factors, Asma, Asthma, Bronchial spasm, Bronchiolitis, Broncoespasmo, Bronquiolitis, Casco, Drug side effect, Efectos secundarios, Helmet, Mascarilla facial total, Nebulización, Nebulizers and vaporizers, Noninvasive ventilation (NIV), Total face mask, Ventilación no invasiva (VNI), Critical Care and Intensive Care Medicine, Intensive Care Units, Pediatric, Statistics, Nonparametric, Aerosol therapy, Tertiary Care Centers, Administration, Inhalation, medicine, Humans, Prospective Studies, Adverse effect, Asthma, Pediatric intensive care unit, Noninvasive Ventilation, Bronchial Spasm, business.industry, Nebulizers and Vaporizers, technology, industry, and agriculture, Masks, Infant, Pneumonia, Length of Stay, medicine.disease, equipment and supplies, Respiration, Artificial, Bronchodilator Agents, Bronchiolitis, Child, Preschool, Emergency medicine, Cohort, Multivariate Analysis, Breathing, Noninvasive ventilation, Head Protective Devices, business, human activities
Abstract

Purpose To evaluate the consequences of using nebulized drugs in patients subjected to noninvasive ventilation (NIV) with total face mask (TFM) and helmet. Design A descriptive analytical study of a prospective patient cohort was carried out. Ambit Pediatric intensive care unit (PICU) of a tertiary hospital. Patients Consecutive sampling was used to include all patients admitted to the PICU and requiring NIV with helmet or TFM over a period of 29 months. No patients were excluded. Interventions Nebulized treatment was added according to medical criteria. Variables of interest Independent variables were age, sex, diagnosis, disease severity, ventilation parameters and nebulized drugs (if administered). Secondary outcomes were duration and failure of NIV, and length of PICU stay. Results The most frequent diagnoses were bronchiolitis (60.5%) and asthma (23%). Patients received NIV for a median of 43 h. Nebulized drugs were administered in 40% of the cases during NIV, and no adverse effects were registered. Using Bayesian statistics, the calculated probability of suffering an adverse effect was 1.3% with helmet and 0.5% with TFM (high density 95% probability intervals). Patients with helmet and nebulized therapy were in more serious condition than those who did not receive nebulization; nevertheless, no differences were observed regarding the need to change to bilevel modality. With TFM, PICU stay was shorter for the same degree of severity (p = 0.033), and the NIV failure rate was higher in patients who did not receive inhaled drugs (p = 0.024). Conclusions The probability of suffering an adverse effect related to nebulization is extremely low when using a helmet or TFM. Inhaled therapy with TFM may shorten PICU stay in some patients.

Published
2018

139. Paediatric acute respiratory distress syndrome incidence and epidemiology (PARDIE): an international, observational study

Author

Khemani, Robinder G, primary, Smith, Lincoln, additional, Lopez-Fernandez, Yolanda M, additional, Kwok, Jeni, additional, Morzov, Rica, additional, Klein, Margaret J, additional, Yehya, Nadir, additional, Willson, Douglas, additional, Kneyber, Martin C J, additional, Lillie, Jon, additional, Fernandez, Analia, additional, Newth, Christopher J L, additional, Jouvet, Philippe, additional, Thomas, Neal J, additional, Abaleke, Eugenia, additional, Ackerman, Kate G, additional, Acuña, Carlos, additional, Adu-Darko, Michelle, additional, Affolter, Jeremy T, additional, Agbeko, Rachel, additional, Al Amoudi, Ahmed, additional, Alahmadti, Ahmad, additional, Aldairi, Nedaa, additional, Alibrahim, Omar, additional, Allen, Kiona, additional, Allen, Christine, additional, Al-Subu, Awni, additional, Althabe, María, additional, Alvear, Jimena, additional, Anil, Ayse Berna, additional, Anthony, Heather, additional, Aramburo, Angela, additional, Arjona Villanueva, David, additional, Ashtari, Neda, additional, Ávila Vera, Antonio, additional, Baines, Paul, additional, Bales, Melissa, additional, Barr, Samantha, additional, Barry, Dana, additional, Baudin, Florent, additional, Beca, John, additional, Belfield, Holly, additional, Beltramo, Fernando, additional, Benken, Laura, additional, Bhalla, Anoopindar, additional, Blom, Andrea, additional, Botta, Priscila, additional, Bourgoin, Pierre, additional, Brezmes, Marta, additional, Briassoulis, George, additional, Bridier, Armelle, additional, Brierley, Joe, additional, Brio Sanagustin, Sonia, additional, Broden, Elizabeth, additional, Butt, Warwick, additional, Bysani, Kris, additional, Camilo, Cristina, additional, Camporesi, Anna, additional, Campos-Miño, Santiago, additional, Can, Fulya Kamit, additional, Capocasa, Patricia, additional, Caro I, Daniel, additional, Carroll, Christopher, additional, Castellani, Pablo, additional, Castillo, Andres E., additional, Chen, Yang, additional, Chima, Ranjit S., additional, Chiusolo, Fabrizio, additional, Cinquegrani, Karina, additional, Coates, Bria, additional, Coronado-Munoz, Alvaro, additional, Cortéz, Ambar, additional, Cruces Romero, Pablo, additional, Cullimore, Melissa, additional, Cvijanovich, Natalie, additional, Dahmer, Mary K., additional, Deep, Akash, additional, Delzoppo, Carmel, additional, Di Nardo, Matteo, additional, Díaz, Franco, additional, Dijkstra, Sandra, additional, Dockery, W. Keith, additional, Dominguez, Troy E., additional, Dumitrascu, Mariana, additional, Dursun, Oguz, additional, Dwarakanathan, Buvana, additional, Elghuwael, Ismail, additional, Emeriaud, Guillaume, additional, Erickson, Simon, additional, Español, Segundo Fernando, additional, Estil, Jim Brian, additional, Feather, Calandra, additional, Feinstein, Yael, additional, Fernández, Analía, additional, Ferreyra, Marcela, additional, Flori, Heidi, additional, Fortini, Yanina Vanesa, additional, Fortune, Peter-Marc, additional, French, Mary Ellen, additional, Gaboli, Mirella, additional, Gale, Helen, additional, García Casas, Paula, additional, García González, Maria, additional, Gautam, Richa, additional, Gedeit, Rainer, additional, Genuini, Mathieu, additional, Gertz, Shira, additional, Giampieri, Martin, additional, Gil Escobar, Carlos, additional, Giuliano Jr, John S., additional, Godoy Mundaca, Loreto, additional, Goni Orayen, Concepción, additional, Gonzalez Gomez, Jose Manuel, additional, Govantes, Beatriz, additional, Guichoux, Julie, additional, Guzman Rivera, Gustavo Alfredo, additional, Haileselassie, Bereketeab, additional, Han, Yong Y, additional, Harrell, Amy, additional, Hartmann, Silvia, additional, Hazwani, Tarek, additional, Hefley, Glenda, additional, Henderson, Grace, additional, Hsing, Deyin D., additional, Hughes-Schalk, Amber, additional, Hume, Janet, additional, Ilia, Stavroula, additional, Inwald, David, additional, Iolster, Thomas, additional, Izquierdo, Ledys María, additional, Jafari-Namin, Shirin, additional, Jaimon, Nancy, additional, Jarillo Quijada, Alberto E, additional, Jarvis, J. Dean, additional, Jayachandran, Chaandini, additional, Jennings, Claire, additional, Jeyapalan, Asumthia S., additional, Jimenez Rivera, Nestor Javier, additional, Jones, Dawn, additional, Kasch, Mary, additional, Keary, Jane't, additional, Kelley, Connor, additional, Kessel, Aaron, additional, Khemani, Robinder, additional, Kida, Yoshiko, additional, King, Caroline, additional, Kneyber, Martin, additional, Kniola, Allison, additional, Krallman, Kelli, additional, Kubis, Sherri, additional, Kustka, Lucinda, additional, Kyo, Michihito, additional, Landry, Luis Martín, additional, Latifi, Samir, additional, Lawton-Woodhall, Angela, additional, Lin, John C., additional, Llorente de la Fuente, Ana M., additional, Lopez Alarcón, Yurika Paola, additional, López Fernández, Yolanda, additional, Lopez-Herce, Jesús, additional, Lum, Lucy Chai See, additional, Macrae, Duncan, additional, Maddux, Aline B., additional, Madurga Revilla, Paula, additional, Mahapatra, Sidharth, additional, Maria, Matthieu, additional, Martínez, Lidia, additional, Martinez de Azagra, Amelia, additional, Martínez León, Alejandro Fabio, additional, Mazzillo Vega, Liliana, additional, McCorkell, Jenni, additional, McIntyre, Karen, additional, Medina, Tania, additional, Medina, Alberto, additional, Mellish, Christie, additional, Mendizabal, Mikel, additional, Merritt, Courtney, additional, Mildner, Reinout, additional, Milesi, Christophe, additional, Modesto I Alapont, Vicent, additional, Monjes, Cecilia, additional, Monjure, Tracey, additional, Montes, María José, additional, Morales Martinez, Antonio, additional, Morgan, Ryan, additional, Mourani, Peter M., additional, Murkowski, Kathy, additional, Murphy, Marie, additional, Napolitano, Natalie, additional, Nerheim, Dan, additional, Nett, Sholeen T., additional, Newth, Christopher, additional, Nofziger, Ryan, additional, Nunez, Maria Jose, additional, Ohshimo, Shinichiro, additional, Onate Vergara, Eider, additional, Ongun, Ebru A, additional, Orqueda, Daniel, additional, Oruganti, Siva, additional, Pagowska-Klimek, Izabela, additional, Palanca Arias, Daniel, additional, Pappachan, Jon, additional, Pardo Carrero, Rosalba, additional, Parker, Margaret M., additional, Parrilla, Julio, additional, Patankar, Nikhil, additional, Pávez Madrid, Paula, additional, Payen, Valerie, additional, Paziencia, Fernando, additional, Pedraza, Claudia, additional, Perez Lozano, Germán, additional, Pilar Orive, Javier, additional, Piñeres Olave, Byron Enrique, additional, Pintimalla, Alyssa, additional, Pinto, Neethi, additional, Plunkett, Adrian, additional, Pon, Steve, additional, Pons Odena, Marti, additional, Poterala, Rossana, additional, Qiao, Haiping, additional, Quiñonez Lopez, Deyanira, additional, Ralston, Kimberly, additional, Ramirez Cortez, Grimaldo, additional, Ratiu, Anna, additional, Rea, Miriam, additional, Reyes Dominguez, Susana, additional, Rodgers, Chiara, additional, Rodriguez Campoy, Patricia, additional, Ronan, Laurie, additional, Rosemary, Deheza, additional, Rowan, Courtney, additional, Sadasivam, Kalaimaran, additional, Sanchez Diaz, Juan Ignacio, additional, Sanders, Ron, additional, Santanelli, James, additional, Sapru, Anil, additional, Schneider, James, additional, Sforza, Jesica, additional, Shea, Sara, additional, Shein, Steven L., additional, Sherring, Claire, additional, Sheward, Victoria, additional, Shime, Nobuaki, additional, Shukla, Avani, additional, Siaba Serrate, Alejandro, additional, Sierra, Yamila, additional, Sikora, Lindsay, additional, Silvestre, Catarina, additional, Singleton, Marcy, additional, Sloniewsky, Daniel, additional, Smith, Rebecca, additional, Song, Hanqiu, additional, Sousa Moniz, Marta, additional, Spaeder, Michael, additional, Spear, Debbie, additional, Spinella, Philip, additional, Starck, Julie, additional, Stoneman, Erin, additional, Su, Felice, additional, Subramanian, Gayathri, additional, Sullivan, Erin, additional, Sundararajan, Santosh, additional, Sweberg, Todd, additional, Sykes, Kim, additional, Tabata, Yuichi, additional, Tai, Chian Wern, additional, Tala, Joana, additional, Tang, Swee Fong, additional, Tantalean, José, additional, Taylor, Ryan, additional, Thomas, Neal, additional, Tibby, Shane, additional, Tieves, Kelly S, additional, Torero, Luis, additional, Torres, Silvio Fabia, additional, Totapally, Balagangadhar, additional, Travert, Brendan, additional, Truemper, Edward, additional, Turón, Gonzalo, additional, Typpo, Katri, additional, Valle, Juan Ramón, additional, Vargas G, Sonia I, additional, Vasquez Hoyos, Pablo, additional, Vasquez Miranda, Daniel, additional, Vavrina, Martin, additional, Vidal, Nilda Águeda, additional, Virk, Manpreet, additional, Walsh, Laura, additional, Wegner Araya, Adriana, additional, Weitz, James, additional, Wellisch, Lawren, additional, Wellman, Paul, additional, Woods, Katherine, additional, Yerovi, Rocio, additional, Yunger, Toni, additional, Zuluaga Orrego, Cesar, additional, and Zurek, Jiri, additional

Published
2019
Full Text
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141. Agaricus subrufescens and Pleurotus ostreatus mushrooms as alternative additives to antibiotics in diets for broilers challenged with Eimeria spp.

Author

Lima, G. A., Barbosa, B. F. S., Araujo, R. G. A. C., Polidoro, B. R., Polycarpo, G. V., Zied, D. C., Biller, J. D., Ventura, G., Modesto, I. M., Madeira, A. M. B. N., and Cruz-Polycarpo, V. C.

Subjects
EIMERIA, PLEUROTUS ostreatus, MUSHROOMS, ANTIBIOTICS, MONENSIN, POULTRY feeding
Abstract

1. The effect of A. subrufescens and P. ostreatus mushrooms as an alternative to antibiotics (avilamycin or monensin sodium) on performance, intestinal morphometry, immunity, and biochemical profile of broilers challenged with Eimeria spp. was studied from 1 to 42 d old. A total of 900 male Cobb® broiler chicks were distributed, according to a completely randomised design, into five treatments with six replicates each. 2. The treatments consisted of: negative control (NC) – basal diet (BD) with no anticoccidial or antibiotic (non-challenged birds); negative control challenged (NCC) – NC fed to Eimeria spp. challenged birds; BD with 0.2% A. subrufescens inclusion for challenged birds (As), BD with 0.2% P. ostreatus inclusion for challenged birds (Po); and a positive control – BD with anticoccidial and antibiotic inclusion for challenged birds (ATB). 3. At 11 d.o., the birds were each inoculated orally with 1 ml solution containing 2 × 105 sporulated oocysts/ml Eimeria acervulina and 2 × 104 sporulated oocysts/ml E. maxima and E. tenella. 4. Birds subjected to Eimeria spp. challenge up to 21 d of age had greater crypt depth, indicating that the presence of undesirable microorganisms had an effect on cell proliferation. 5. At 21 d old, the birds receiving ATB had higher average weight gain (AWG), feed intake (AFI), and feed conversion ratio (FCR) compared to those fed diets supplemented with mushrooms (As or Po). For the total rearing period (42 days), the birds that received ATB had higher AWG and AFI (P < 0.001) compared to those that received As or Po diets. Feeding avilamycin did not affect (P = 0.0676) FCR compared to the As or Po diet groups. 6. From the morphometric and blood analyses there were no differences between broilers fed ATB, Po or As diets in either rearing periods. However, Po and As supplementation lowered blood triglyceride levels. At 21d there was a difference (P < 0.05) for MCV and haemoglobin, in which the mushrooms were similar to the antibiotic. At 42 d, there was a difference (P < 0.05) in haematocrit, erythrocyte, MCV, H: L, protein and albumin variables, in which the use of mushrooms was similar to the positive control, demonstrating that both (mushrooms and antibiotics) promoted a certain improvement in the health of the chickens. 7. A. subrufescens and P. ostreatus can be used in broiler diets without compromising intestinal or haematological status, however, these ingredients did not result in improvements in performance. [ABSTRACT FROM AUTHOR]

Published
2021
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143. High-flow nasal cannula therapy versus non-invasive ventilation in children with severe acute asthma exacerbation: An observational cohort study

Author

J. Pilar, V. Modesto i Alapont, O. Lopez-Macias, D. Garcia-Urabayen, Y.M. Lopez-Fernandez, and I. Amores-Hernandez

Subjects
Male, Pediatrics, medicine.medical_specialty, Adolescent, Exacerbation, Asthma exacerbation, Status Asthmaticus, Intensive Care Units, Pediatric, Critical Care and Intensive Care Medicine, medicine.disease_cause, Hospitals, University, Tertiary Care Centers, 03 medical and health sciences, 0302 clinical medicine, medicine, Cannula, Humans, Child, Children, Proportional Hazards Models, Retrospective Studies, Pediatric intensive care unit, Noninvasive Ventilation, business.industry, Oxygen Inhalation Therapy, Infant, 030208 emergency & critical care medicine, Retrospective cohort study, Length of Stay, Combined Modality Therapy, Critical care, Treatment Outcome, 030228 respiratory system, Child, Preschool, Emergency medicine, High-flow nasal cannula, Breathing, Non-invasive ventilation, Length of stay, Female, Observational study, business, Nasal cannula, Cohort study, Severe acute asthma
Abstract

Introduction: The present study describes our experience with the high -flow humidified nasal ventilation; cannula (HFNC) versus non-invasive ventilation (NIV) in children with severe acute asthma High-flow nasal exacerbation (SA). Methods: An observational study of a retrospective cohort of 42 children with SA admitted Asthma exacerbation; to a Pediatric Intensive Care Unit (PICU) for non-invasive respiratory support was made. The Critical care; primary outcome measure was failure of initial respiratory support (need to escalate from HFNC Children; to NIV or from NIV to invasive ventilation). Secondary outcome measures were the duration of Length of stay respiratory support and PICU length of stay (LOS). Results: Forty-two children met the inclusion criteria. Twenty (47.6%) received HFNC and 22 (52.3%) NIV as initial respiratory support. There were no treatment failures in the NIV group. However, 8 children (40%) in the HFNC group required escalation to NIV. The PICU LOS was similar in both the NW and HFNC groups. However, on considering the HFNC failure subgroup, the median length of respiratory support was 3-fold longer (63 h) and the PICU LOS was also longer compared with the rest of subjects exhibiting treatment success. Conclusions: Despite its obvious limitations, this observational study could suggest that HFNC in some subjects with SA may delay NW support and potentially cause longer respiratory support, and longer PICU LOS. (C) 2017 Elsevier Espana, S.L.U. y SEMICYUC. All rights reserved.

Published
2017

144. La vacunación rutinaria del virus varicela-zóster reduce la incidencia de varicela grave, sin alterar las hospitalizaciones por herpes zóster

Author

A. Gimeno Díaz de Atauri and V. Modesto i Alapont

Subjects
Pediatrics, Perinatology and Child Health
Abstract

Se ha publicado recientemente un articulo sobre el impacto de las distintas estrategias de vacunacion en Espana1. Los autores concluyen que en Espana las infecciones graves por varicela han disminuido desde la puesta en marcha del programa de vacunacion rutinaria en 2006. Esta disminucion ha sido significativamente mayor en las comunidades autonomas que se decidieron por la estrategia de vacunarcon dos dosisa todos los ninos de 15-18 meses, frente a las que optaron por vacunar solo a los adolescentes susceptibles. Esta diferente estrategia no ha afectado a la tasa de hospitalizacion por herpes zoster, que ha ido incrementandose ligeramente, principalmente en los mayores de 84 anos. Tras la lectura critica de dicho articulo, se puede concluir que, efectivamente, la incidencia de varicela grave se reduce con la vacunacion de los adolescentes (de 10 a 14 anos) sanos susceptibles y que este beneficio se duplica con la estrategia de vacunar a todos los ninos de 15-18 meses de edad. Aunque no queda demostrada una relacion causal con la vacunacion, la incidencia global de herpes zoster grave sigue una tendencia de incremento progresivo, sobre todo en los ancianos. Por este motivo, la eficiencia social de la vacunacion universal de los lactantes aun esta por establecer.

Published
2014
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147. Good science

Author

V, Modesto I Alapont

Published
2016

148. Relying on objective data: the glass half empty of high-flow nasal cannula in bronchiolitis

Author

Vicent Modesto i Alapont, Alberto Medina Villanueva, and Martí Pons Ódena

Subjects
medicine.medical_specialty, Oxygen inhalation therapy, business.industry, Oxygen Inhalation Therapy, 030208 emergency & critical care medicine, Objective data, Critical Care and Intensive Care Medicine, medicine.disease, medicine.disease_cause, Cannula, Surgery, 03 medical and health sciences, 0302 clinical medicine, Bronchiolitis, medicine, Humans, 030212 general & internal medicine, High flow, business, Nasal cannula
Published
2017
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