The Southwest Respiratory and Critical Care Chronicles

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EISSN : 2325-9205
Total articles ≅ 643
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Latest articles in this journal

Medha Ghose , Maehali Patel, Kenneth Nugent
The Southwest Respiratory and Critical Care Chronicles, Volume 8, pp 47-54; doi:10.12746/swrccc.v8i36.777

Quinine has been used for centuries as a drug for malaria treatment. Chloroquine (CQ) and its 4-aminoquinoline analog hydroxychloroquine (HCQ) have been used during the last two centuries for the treatment and prophylaxis of malaria. Since the inception of COVID-19 in Wuhan, China, in late December 2019, physicians and researchers have tried to use old drugs to treat this pandemic. This review discusses possible modes of action of CQ and HCQ in vitro that might treat this viral infection. The diverse cellular, immunological, and antiviral mechanisms reported in the literature suggest that CQ and HCQ might be useful drugs against COVID-19. Both drugs increase the pH in intracellular organelles, which limits viral replication. However, randomized controlled trials have not found any benefit as either for prophylaxis or treatment of COVID-19. In addition, fatal adverse events associated with these drugs have resulted in the issuance of precautionary measures when recommending these drugs in COVID-19 patients. The search for other innovative drugs to cure COVID-19 and an expedited approval for a vaccine are ongoing at present.
Shengping Yang , Gilbert Berdine
The Southwest Respiratory and Critical Care Chronicles, Volume 8, pp 74-77; doi:10.12746/swrccc.v8i36.773

Walter Duarte , Victor Montalvan
The Southwest Respiratory and Critical Care Chronicles, Volume 8, pp 86-89; doi:10.12746/swrccc.v8i36.771

The Southwest Respiratory and Critical Care Chronicles, Volume 8, pp 70-73; doi:10.12746/swrccc.v8i36.769

Sofia Prieto , Omid Hosseini, Pooja Sethi
The Southwest Respiratory and Critical Care Chronicles, Volume 8, pp 58-60; doi:10.12746/swrccc.v8i36.767

Echocardiography is a readily available imaging modality used to evaluate cardiac function. Recently, the addition of strain measurements has provided additional information by evaluating the intrinsic myocardial function and detecting subclinical systolic dysfunction. As with any emerging technique or application, it is imperative to understand how the information gathered in the study can be applied to clinical practice. This review article examines how echocardiographic strain analysis can be applied to clinical practice and its use as a promising prognostic resource in many cardiovascular conditions.
Jie Pan , Amputch Karukote, Eri Shoji
The Southwest Respiratory and Critical Care Chronicles, Volume 8, pp 61-65; doi:10.12746/swrccc.v8i36.761

A burst-suppression pattern is an electroencephalographic pattern characterized by a quasi-periodic high amplitude “burst” alternating with periods of low or flatline “suppression.” Recognizing and understanding this pattern is helpful for clinical management in intensive care units. Pathological burst-suppression is commonly seen in post cardiac arrest comatose patients. It can also be induced by anesthetics or hypothermia. A burst-suppression pattern in anoxic brain injury generally predicts a poor prognosis; however, exceptions do occur. Inducing burst-suppression by general anesthetics can be used to abort super-refractory status epilepticus. This article will discuss this unique EEG pattern, including basic mechanisms, related clinical conditions, and recent research updates.
Ashish Sarangi, E.L. Domingo-Johnson , Lance Mwangi, Arham Siddiqui, Chia Hsu
The Southwest Respiratory and Critical Care Chronicles, Volume 8, pp 55-57; doi:10.12746/swrccc.v8i36.763

Obstructive sleep apnea (OSA) is a common sleep disorder characterized by collapse or obstruction of the airway with associated hypoxemia. Physiological conditions associated with OSA include hypertension and cardiac arrhythmias; however, OSA is also linked to psychological illnesses and disorders. This study focuses on the relation between OSA and psychological disorders in children and adults by reviewing pertinent literature. The review was conducted using PubMed, which yielded 56 articles between 2015 and 2020. Primary findings included links of OSA to neurological deficiencies, such as decreases in visuospatial ability, attention, and memory, as well as structural defects (e.g., edema and gliosis). Studies also showed a bidirectional relationship between OSA and major depressive disorder. A similar finding is observed between OSA and bipolar disorder, which can be aggravated by atypical antipsychotic treatments. It is important to continue to investigate the clinical manifestations of OSA in adult and children populations to prevent, diagnose, and treat related psychological conditions.
Cameron Clarke , Timothy Truong
The Southwest Respiratory and Critical Care Chronicles, Volume 8, pp 78-80; doi:10.12746/swrccc.v8i36.733

We report two cases of bilateral attempted self-enucleation with severe sequalae following the traumatic events. Case 1 involves an incarcerated schizophrenic patient who presented multiple times following failed enucleation attempts before finally succeeding with bilateral enucleation. Case 2 is an acutely psychotic individual who successfully enucleated their left eye with attempted removal of the right eye. They developed a massive ischemic stroke immediately following the traumatic event. We also discuss other complications, management, and prevention.
Mohamed Elmassry , Rubayat Rahman, Pablo Paz, Barbara Mantilla, Scott Shurmur, Erwin Argueta-Sosa
The Southwest Respiratory and Critical Care Chronicles, Volume 8, pp 1-9; doi:10.12746/swrccc.v8i36.757

Acute decompensated heart failure (ADHF) is the leading cause of hospitalization in patients older than 65 years. It continues to increase in prevalence and is associated with significant mortality and morbidity including frequent hospitalizations. The American Heart Association is predicting that more than 8 million Americans will have heart failure by 2030 and that the total direct costs associated with the disease will rise from $21 billion in 2012 to $70 billion in 2030. The definition of ADHF has important limitations, and its management differs significantly from that of chronic heart failure. Although many large, randomized, controlled clinical trials have been conducted in patients with chronic heart failure, it was not until recently that more studies began to address the management of ADHF. The mainstay of ADHF management involves identification of precipitating factors, oxygen supplementation, sodium and fluid restriction, and diuresis. The phenomenon of diuretic resistance is a significant obstacle to relief of congestion and is a field of active investigation. Other important adjuncts to treatment include noninvasive ventilation, inotropes, vasopressors, nitrates, opiates, and vasopressin receptor antagonists. In this review, we will discuss the terminology and classification of ADHF, and review the multiple modalities and strategies available for the management of this disorder. Keywords: heart failure, medical management, complications, devices, palliative care
Barbara Mantilla , Pablo Paz, Rubayat Rahman, Mohamed Elmassry, Scott Shurmur, Erwin Argueta-Sosa
The Southwest Respiratory and Critical Care Chronicles, Volume 8, pp 10-22; doi:10.12746/swrccc.v8i36.759

Acute decompensated heart failure is a clinical syndrome involving the congestion of vital organs, such as the kidneys, liver, and brain, leading to loss of autoregulation and multiorgan failure. The interaction between organ systems is bi-directional and complex; it cannot be explained by hypoperfusion alone. Despite the multiple signs and symptoms that arise with systemic congestion, there are limitations in the assessment of volume status based only on clinical evaluation. Invasive hemodynamic monitoring is an adjunctive diagnostic and prognostic tool in acute decompensated heart failure when standard therapy fails and/or leads to worsening renal function as well as for the evaluation of advanced therapy options. This review will discuss the use of temporary mechanical circulatory support devices in cardiogenic shock and the expected outcomes for advanced heart failure with the implementation of left ventricular assist devices and cardiac transplantation.
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