Biomedical subjects

Antara Mallampalli

Publications and source records attributed to Antara Mallampalli.

5 recordsLinked to original sources

PubMed2006

Smoking and systemic disease.

Cigarette smoking is associated with a number of adverse health effects, including well-established links to cardiopulmonary disease and several cancers. Some of the other important systemic diseases associated with smoking are the subjects of this article, such as diabetes mellitus and insulin resistance, and thyroid diseases. Also reviewed here is the impact of smoking on male and female infertility, on selected dermatologic conditions, and on gastrointestinal diseases including peptic ulcer and inflammatory bowel diseases.

Endocrine System Diseases↗

PubMed2005

Cardiac arrest in pregnancy and somatic support after brain death.

OBJECTIVE: To review the important causes of cardiopulmonary arrest during pregnancy and the recommended modifications to resuscitation protocols when applied to pregnant patients, including the indications for perimortem cesarean section and the expected fetal outcomes, and to review the literature regarding extended somatic support after brain death during pregnancy. DATA SOURCES: MEDLINE review of publications relating to cardiac arrest and resuscitation in pregnancy, physiologic changes after brain death, and attempted somatic support of brain-dead pregnant women. CONCLUSIONS: Cardiac arrest during pregnancy is rare, but it is important to recognize the causes, which may be either unrelated to pregnancy or unique to the pregnant woman. For the most part, the resuscitation protocol is the same as for nonpregnant victims of cardiac arrest, with a few important modifications, including especially the need for relieving aortocaval compression by the gravid uterus, the need for rapid intubation, and the importance of rapid perimortem cesarean delivery when indicated. In those rare cases of brain death occurring in a pregnant patient, continued somatic support of the mother may be possible, even for prolonged periods, to extend the pregnancy and further fetal maturation. The expected physiologic changes after brain death, challenges to successful somatic support, and specific recommendations regarding organ support of the brain-dead pregnant woman are reviewed.

Brain Death↗

PubMed2004

Cardiopulmonary resuscitation and somatic support of the pregnant patient.

Cardiopulmonary arrest during pregnancy is a rare event that critical care clinicians must be prepared to manage. The causes of cardiopulmonary arrest during pregnancy, recommended modifications to cardiopulmonary resuscitation protocols that are specific to pregnancy, indications for and timing of perimortem cesarean delivery, and the expected fetal outcomes are reviewed. Rarely, brain death of a pregnant patient may occur in which continued support of the mother is possible to prolong the pregnancy and improve fetal outcome. Prolonged somatic support of pregnant patients who are brain dead presents specific management challenges, but has been accomplished. The physiologic changes that occur after brain death and recommendations for somatic support of the brain dead pregnant patient also are reviewed.

Brain Death↗

PubMed2004

Smoking and systemic disease.

Cigarette smoking is associated with a number of adverse health effects, including well-established links to cardiopulmonary disease and several cancers. Some of the other important systemic diseases associated with smoking are the subjects of this article, such as diabetes mellitus and insulin resistance and thyroid diseases. Also reviewed here is the negative impact of smoking on male and female infertility, on selected dermatologic conditions, and on gastrointestinal diseases including peptic ulcer and inflammatory bowel diseases.

Endocrine System Diseases↗

PubMed2004

Nutritional management of the patient with chronic obstructive pulmonary disease.

The prevalence and prognostic importance of malnutrition in chronic obstructive pulmonary disease (COPD), the factors that contribute to development of nutritional depletion, and the available evidence regarding effects of nutrition support in these patients are the subjects of this review. Nutritional depletion, as indicated by weight loss and loss of lean body mass, is a common complication of advanced COPD (particularly, but not limited to, the emphysematous type). Low body weight or recent weight loss and in particular depleted lean body mass in patients with COPD have been shown to be independent predictors of mortality, outcomes after acute exacerbations, hospital admission rates, and need for mechanical ventilation. The factors thought to contribute to nutritional depletion in these patients include elevated resting and activity-related energy expenditure, reduced dietary intake relative to resting energy expenditure, accelerated negative nitrogen balance, particularly during acute exacerbations of COPD, medication effects, and perhaps most importantly an elevated systemic inflammatory response. Studies to date suggest that, although it can help limit weight loss and negative energy balance in these patients, the effect of nutritional supplementation alone on clinically significant outcomes such as pulmonary function and exercise capacity is minimal. However, nutritional supplementation may have a role in the management of COPD when provided as part of an integrated rehabilitation program incorporating a structured exercise component as an anabolic stimulus.

Journal Article↗