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Respiratory Infections PostersSESSION TYPE: Poster PresentationsPRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PMPURPOSE: Infections are common important cause of severe complications in sickle cell patients, a person may not know what brought severe pain named crisis but infection common trigger .The Pneumonia Severity Index and CURB-65 predict outcomes in community acquired pneumonia but have limitations. Procalcitonin, a biomarker of bacterial infection, may provide prognostic information in community-acquired pneumonia. Our objective is to describe if procalcitonin in community-acquired pneumonia may Provides prognostic information with the Pneumonia Severity Index and CURB-65 in sickle cell adult patients. ⋯ The following authors have nothing to disclose: Sherif Alsayed, Samar MarzoukNo Product/Research Disclosure Information.
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Transplantation PostersSESSION TYPE: Poster PresentationsPRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PMPURPOSE: Share our experience in pediatric lung transplantation, survival rates and analyze the results in comparison to worldwide experience. ⋯ The following authors have nothing to disclose: José González García, Sebastian Peñafiel, Eugenia Libreros Niño, Diana Baquero Velandia, Carlos Jordá Aragón, Victor Calvo Medina, Gabriel Sales Badia, Juan Escrivá, Ángel García Zarza, Juan Pastor GuillemNo Product/Research Disclosure Information.
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Critical CareSESSION TYPE: Slide PresentationsPRESENTED ON: Monday, March 24, 2014 at 10:45 AM - 11:45 AMPURPOSE: Patients with severe alcohol withdrawal often require escalating doses of benzodiazepines and intubation with mechanical ventilation which leads to prolonged Intensive Care Unit(ICU) stays. Earlier studies suggest dexmedetomidine is effective in reducing benzodiazepine dosage and autonomic symptoms seen with alcohol withdrawal. We report a retrospective analysis of 53 ICU patients treated for alcohol withdrawal, conducted to compare treatment with benzodiazepine alone to those receiving dexmedetomidine as escalation or substitution therapy. ⋯ The following authors have nothing to disclose: Amit Kachalia, Kinjal Kachalia, Shivaraj Nagalli, Habibur Rahman, Ricardo Lopez, Vincent RizzoNo Product/Research Disclosure Information.
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COPD PostersSESSION TYPE: Poster PresentationsPRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PMPURPOSE: Treatment guidelines for chronic obstructive pulmonary disease (COPD) recommend combination therapy of 2 or more long-acting bronchodilators with different mechanisms of action. Here we report the long-term safety of a fixed-dose combination of aclidinium bromide, a long-acting muscarinic antagonist indicated for maintenance treatment of COPD-associated bronchospasm, with formoterol fumarate, a long-acting β2-agonist, in patients with COPD. ⋯ Barry Make: Consultant fee, speaker bureau, advisory committee, etc.: Barry Make received payment for service on the advisory boards of Forest Pharmaceuticals, AstraZeneca, Novartis, Merck, Boehringer Ingelheim, Pfizer, Ikaria, and GlaxoSmithKline, consulting fees from Astellas Pharma, and Talecris Biotherapeutics, lecture fees from GlaxoSmithKline, Boehringer Ingelheim, Pfizer, and Forest Pharmaceuticals, payment for video presentation preparation from Boehringer Ingelheim and Pfizer, payment for document reviews from Spiration., Grant monies (from industry related sources): Barry Make received grant support from AstraZeneca, GlaxoSmithKline, Pfizer, Nabi Biopharmaceuticals, Boehringer Ingelheim, Forest, and Sunovion, Grant monies (from sources other than industry): Barry Make received grant support from the National Heart Lung, and Blood Institute, James Donohue: Consultant fee, speaker bureau, advisory committee, etc.: Dr. Donohue has received consultant/speaker/advisory fees from Novartis, GlaxoSmithKline, Boehringer-Ingelheim, Forest and Pfizer Xiaoyun Zhong: Employee: X. Zhong is an employee of Forest Research Institute, Inc. Anne Leselbaum: Employee: Anne Leselbaum is an employee of Almirall S.A. Cynthia Caracta: Employee: Cynthia Caracta is an employee of Forest Research Institute, Inc., Shareholder: Cynthia Caracta is is a stockowner and has received stock options from Forest Laboratories, Inc.Aclidinium bromide (Tudorzo/Pressair, Eklira/Genuair, Breo/Ellipta) is approved for the maintenance treatment of COPD-associated bronchspasm. The fixed-dose combination of aclidinium bromide/formoterol fumarate is being developed, but not yet approved, for its commercial use for the treatment of COPD.
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The use of mechanical circulatory support (MCS) devices has increased sixfold since 2006. Although there is an established legal and ethical consensus that patients have the right to withdraw and withhold life-sustaining interventions when burdens exceed benefits, this consensus arose prior to the widespread use of MCS technology and is not uniformly accepted in these cases. ⋯ Our center recently encountered the challenge of an awake and functionally improving patient with a total artificial heart (TAH) who requested its deactivation. We present a narrative description of this case with discussion of the following questions: (1) Is it ethically permissible to deactivate this particular device, the TAH? (2) Are there any particular factors in this case that are ethical contraindications to proceeding with deactivation? (3) What are the specific processes necessary to ensure a compassionate and respectful deactivation? (4) What proactive practices could have been implemented to lessen the intensity of this case's challenges? We close with a list of recommendations for managing similar cases.