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  1. Article: Volumetric capnography in acute respiratory distress syndrome: is the era of day-to-day monitoring finally here?

    Ghamra, Ziad W / Arroliga, Alejandro C

    Respiratory care

    2005  Volume 50, Issue 4, Page(s) 457–458

    MeSH term(s) Capnography/instrumentation ; Capnography/methods ; Critical Care/methods ; Humans ; Monitoring, Physiologic/instrumentation ; Monitoring, Physiologic/methods ; Respiratory Dead Space ; Respiratory Distress Syndrome, Adult/diagnosis ; Respiratory Distress Syndrome, Adult/physiopathology
    Language English
    Publishing date 2005-04
    Publishing country United States
    Document type Comment ; Editorial
    ZDB-ID 603252-7
    ISSN 0020-1324 ; 0098-9142
    ISSN 0020-1324 ; 0098-9142
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Primary pulmonary hypertension: an overview of epidemiology and pathogenesis.

    Ghamra, Ziad W / Dweik, Raed A

    Cleveland Clinic journal of medicine

    2003  Volume 70 Suppl 1, Page(s) S2–8

    Abstract: Pulmonary arterial hypertension (PAH) refers to a group of diseases characterized by high pulmonary artery pressure of unknown mechanism. Primary pulmonary hypertension (PPH) is the idiopathic subset of PAH that affects a mostly young population and is ... ...

    Abstract Pulmonary arterial hypertension (PAH) refers to a group of diseases characterized by high pulmonary artery pressure of unknown mechanism. Primary pulmonary hypertension (PPH) is the idiopathic subset of PAH that affects a mostly young population and is more common in females than in males. A familial form of PPH accounts for about 6% of cases, and its autosomal dominant gene was recently identified. Pulmonary arterial hypertension is histologically characterized by endothelial and smooth muscle cell proliferation, medial hypertrophy, and thrombosis in situ. The pathogenesis of PAH remains unclear. Elevated pulmonary vascular resistance seems to result from an imbalance between locally produced vasodilators and vasoconstrictors, in addition to vascular wall remodeling. Nitric oxide, a locally produced selective pulmonary vasodilator, appears to play a central role in the pathobiology of PAH.
    MeSH term(s) Endothelial Growth Factors/metabolism ; Endothelin-1/metabolism ; Endothelium, Vascular/metabolism ; Endothelium, Vascular/physiopathology ; Female ; Global Health ; Humans ; Hypertension, Pulmonary/epidemiology ; Hypertension, Pulmonary/etiology ; Hypertension, Pulmonary/genetics ; Hypertension, Pulmonary/metabolism ; Hypertension, Pulmonary/physiopathology ; Male ; Muscle, Smooth, Vascular/metabolism ; Muscle, Smooth, Vascular/physiopathology ; Nitric Oxide/metabolism ; Prostaglandins/metabolism ; Retrospective Studies ; Sex Factors ; Thrombosis/complications
    Chemical Substances Endothelial Growth Factors ; Endothelin-1 ; Prostaglandins ; Nitric Oxide (31C4KY9ESH)
    Language English
    Publishing date 2003-04-22
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 639116-3
    ISSN 0891-1150
    ISSN 0891-1150
    DOI 10.3949/ccjm.70.suppl_1.s2
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Hypothyroidism and pulmonary arterial hypertension.

    Ghamra, Ziad W / Dweik, Raed A / Arroliga, Alejandro C

    The American journal of medicine

    2004  Volume 116, Issue 5, Page(s) 354–355

    MeSH term(s) Eisenmenger Complex/complications ; Humans ; Hypertension, Pulmonary/complications ; Hypothyroidism/complications ; Hypothyroidism/diagnosis ; Scleroderma, Systemic/complications
    Language English
    Publishing date 2004-03-01
    Publishing country United States
    Document type Letter
    ZDB-ID 80015-6
    ISSN 1555-7162 ; 1873-2178 ; 0002-9343 ; 1548-2766
    ISSN (online) 1555-7162 ; 1873-2178
    ISSN 0002-9343 ; 1548-2766
    DOI 10.1016/j.amjmed.2003.09.040
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Use of noninvasive positive-pressure ventilation on the regular hospital ward: experience and correlates of success.

    Farha, Samar / Ghamra, Ziad W / Hoisington, Edward R / Butler, Robert S / Stoller, James K

    Respiratory care

    2006  Volume 51, Issue 11, Page(s) 1237–1243

    Abstract: Background: Though noninvasive positive-pressure ventilation (NPPV) is efficacious in treating patients with exacerbations of chronic obstructive pulmonary disease, little attention has been given to the optimal venue in which to provide NPPV. The aim ... ...

    Abstract Background: Though noninvasive positive-pressure ventilation (NPPV) is efficacious in treating patients with exacerbations of chronic obstructive pulmonary disease, little attention has been given to the optimal venue in which to provide NPPV. The aim of this prospective observational study was to assess the outcomes of NPPV initiated for acute respiratory failure on the regular in-patient ward.
    Methods: Starting in May 2004, all patients started on NPPV for acute respiratory failure on regular nursing floors of the Cleveland Clinic Hospital were identified. Patients were divided into 2 groups: do-not-intubate (DNI) and non-DNI. NPPV failure was defined as the need to transfer the patient to the intensive care unit (ICU).
    Results: Seventy-six patients were enrolled. The most common cause of acute respiratory failure was exacerbation of chronic obstructive pulmonary disease (41%), followed by pulmonary edema, pneumonia, obesity-hypoventilation, and neuromuscular illness. Of the 62 non-DNI patients, 19 (31%) failed NPPV on the regular ward and required transfer to the ICU. Variables associated with NPPV failure were amount of secretions (p = 0.04), etiology of respiratory failure (pneumonia was associated with the highest failure rate, p = 0.015), and infiltrate on the chest radiograph (p = 0.036). Seven of the 14 (50%) DNI patients died during hospitalization.
    Conclusions: Results of this observational study show that noninvasive positive-pressure ventilation is frequently used on the regular hospital ward and that the success rate is similar to that reported in series in which NPPV is used in the ICU.
    MeSH term(s) Aged ; Female ; Hospitalization ; Humans ; Intubation ; Male ; Middle Aged ; Ohio ; Outcome Assessment (Health Care) ; Positive-Pressure Respiration/methods ; Prospective Studies ; Pulmonary Disease, Chronic Obstructive ; Respiratory Insufficiency/therapy
    Language English
    Publishing date 2006-11
    Publishing country United States
    Document type Journal Article
    ZDB-ID 603252-7
    ISSN 0020-1324 ; 0098-9142
    ISSN 0020-1324 ; 0098-9142
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  5. Article: Incidence of ARDS in an adult population of northeast Ohio.

    Arroliga, Alejandro C / Ghamra, Ziad W / Perez Trepichio, Alejandro / Perez Trepichio, Patricia / Komara, John J / Smith, Andre / Wiedemann, Herbert P

    Chest

    2002  Volume 121, Issue 6, Page(s) 1972–1976

    Abstract: Study objectives: To assess the incidence of the ARDS in a well-defined adult population.: Design: Kaiser Permanente of northeast Ohio, a health maintenance organization, uses the Cleveland Clinic Foundation as its only tertiary care center. In an ... ...

    Abstract Study objectives: To assess the incidence of the ARDS in a well-defined adult population.
    Design: Kaiser Permanente of northeast Ohio, a health maintenance organization, uses the Cleveland Clinic Foundation as its only tertiary care center. In an ongoing prospective assessment in the Cleveland Clinic ICUs, we identified adult Kaiser Permanente patients with ARDS between 1996 and 1999. ARDS was defined according to the 1994 American-European Consensus Conference criteria. The denominator in the incidence calculation was the adult members of Kaiser Permanente of each year of the study period, and the numerator was the new adult ARDS patients in this particular year. The cause of ARDS, the mortality, and the cause of death were retrospectively identified, as well as other characteristics of the study population.
    Results: ARDS was diagnosed in 66 patients during the 3-year study period. The incidence per 100,000 population was 11.4 in 1996, 19.8 in 1997, and 14.4 in 1998; the overall incidence was 15.3/100,000/yr. The mean PaO(2)/fraction of inspired oxygen (+/- SD) was 110.8 +/- 37.8, the mean APACHE II was 23.4 +/- 6.9, and the mean ICU stay was 12.0 +/- 9.5 days. The most common cause of ARDS was direct lung injury (75.8%), and the most common cause of death was septic shock (53.8%).
    Conclusion: The incidence of ARDS in an adult population in northeast Ohio was 15.3/100,000/yr, a number that is slightly higher but comparable to recent estimates reported by other researchers.
    MeSH term(s) Female ; Humans ; Incidence ; Male ; Middle Aged ; Ohio ; Respiratory Distress Syndrome, Adult/epidemiology ; Retrospective Studies
    Language English
    Publishing date 2002-01-30
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1032552-9
    ISSN 1931-3543 ; 0012-3692
    ISSN (online) 1931-3543
    ISSN 0012-3692
    DOI 10.1378/chest.121.6.1972
    Database MEDical Literature Analysis and Retrieval System OnLINE

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