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https://www.readbyqxmd.com/read/29146517/nanomedicine-safety-in-preclinical-and-clinical-development-focus-on-idiosyncratic-injection-infusion-reactions
#1
REVIEW
Seyed Moein Moghimi
Injection/infusion reactions to nanopharmaceuticals (and particulate drug carriers) are idiosyncratic and well documented. The molecular basis of nanoparticle-mediated injection reactions is debatable, with two hypotheses as front-runners. The first is complement-activation-related 'pseudoallergy', where a causal role for nanoparticle-mediated complement activation in injection/infusion reactions is considered. However, the second hypothesis (the rapid phagocytic response hypothesis) states a transitional link from robust clearance of nanoparticles (NPs) from the blood by strategically placed responsive macrophages to adverse hemodynamic and cardiopulmonary reactions, regardless of complement activation...
November 13, 2017: Drug Discovery Today
https://www.readbyqxmd.com/read/29129343/prognostic-value-of-hyperlactatemia-and-lactate-clearance-after-mitral-valve-surgery
#2
Adam S Evans, Matthew A Levin, Hung-Mo Lin, Ken Lee, Menachem M Weiner, Anelechi Anyanwu, David H Adams, Alexander J C Mittnacht
OBJECTIVES: Blood lactate is frequently used to guide management in critically ill patients. In patients undergoing mitral valve surgery, an elevated lactate level is frequently observed; however, overall mortality is low. The authors hypothesized that hyperlactemia is not a useful predictor of poor outcomes in this patient population. The main aim of this study was to explore how blood lactate level and lactate clearance are associated with 30-day mortality and major adverse events in patients undergoing mitral valve surgery...
August 2, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28994675/comparison-of-the-renoprotective-effect-of-dexmedetomidine-and-dopamine-in-high-risk-renal-patients-undergoing-cardiac-surgery-a-double-blind-randomized-study
#3
Rabie Soliman, Mohamed Hussien
OBJECTIVE: The purpose of the current study was to compare the renoprotective effects of continuous infusion of dexmedetomidine and dopamine in high-risk renal patients undergoing cardiac surgery. DESIGN: A double-blind randomized study. SETTING: Cardiac Centers. PATIENTS: One hundred and fifty patients with baseline serum creatinine level ≥1.4 mg/dl were scheduled for cardiac surgery with cardiopulmonary bypass. INTERVENTION: The patients were classified into two groups (each = 75): Group Dex - the patients received a continuous infusion of dexmedetomidine 0...
October 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28969195/laparoscopic-versus-open-repair-of-para-umbilical-hernia-a-prospective-comparative-study-of-short-term-outcomes
#4
Sreeharsha Korukonda, Anandhi Amaranathan, Vishnu Prasad Nelamangala Ramakrishnaiah
INTRODUCTION: Para-Umbilical Hernia (PUH) is one of the most common surgical problems. Since the prosthetic repair has become the standard of practice for inguinal hernia management, the same has been adapted for para-umbilical hernia management with better outcome. There is still debate going on regarding the optimal surgical approach. There are very few prospective studies comparing the laparoscopic and open method of para-umbilical hernia mesh repair. This study compared the short term outcomes following laparoscopic versus open mesh repair of PUH...
August 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28950435/lung-clearance-index-lci-as-a-predictor-of-exercise-limitation-among-cf-patients
#5
Vasiliki Avramidou, Elpis Hatziagorou, Asterios Kampouras, Helge Hebestreit, Eleana Kourouki, Fotis Kirvassilis, John Tsanakas
INTRODUCTION: FEV1 is often considered the gold standard to monitor lung disease in cystic fibrosis (CF). Recently, there has been increasing interest in multiple breath washout (MBW) and cardiopulmonary exercise testing (CPET) as alternative or even more sensitive techniques. However, limited data exist on associations among the above methods. AIM: To evaluate the correlations between outcome measures of MBW and CPET and to examine if ventilation inhomogeneity can predict exercise intolerance...
September 26, 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/28882651/in-cystic-fibrosis-lung-clearance-index-is-sensitive-to-detecting-abnormalities-appearing-at-exercise-in-children-with-normal-spirometry
#6
Riyadh Chelabi, Thibaud Soumagne, Alicia Guillien, Marc Puyraveau, Bruno Degano
Symptom-limited incremental cardiopulmonary exercise test was performed in school-age children with clinically stable cystic fibrosis (CF), all with normal spirometry. Physiological parameters were compared between patients with normal lung clearance index (LCI; n=6) and patients with elevated LCI (n=6). Dyspnoea ratings during exercise were similar in both groups. Although no patient had significant dynamic hyperinflation, end-expiratory lung volumes were higher throughout exercise in patients with elevated LCI...
September 4, 2017: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/28858859/independent-risk-factors-and-2-year-outcomes-of-acute-kidney-injury-after-surgery-for-congenital-heart-disease
#7
Daishi Hirano, Akira Ito, Akifumi Yamada, Daisuke Kakegawa, Saori Miwa, Chisato Umeda, Kosuke Chiba, Yoichi Takemasa, Ai Tokunaga, Hiroyuki Ida
BACKGROUND: Data are limited regarding risk factors for acute kidney injury (AKI) following cardiac surgery in children with congenital heart disease (CHD). This observational study was performed to examine temporal trends in AKI incidence according to the Pediatric Risk, Injury, Failure, Loss, End-Stage Renal Disease (pRIFLE) criteria, identify independent risk factors for AKI after cardiac surgery, and examine associations between AKI and long-term mortality. METHODS: We retrospectively evaluated 418 patients (259 males, 159 females; median age, 5 months) who underwent cardiac surgery for CHD between April 2007 and August 2013...
2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/28828590/direct-reopening-of-the-occluded-hepatic-veins-of-budd-chiari-syndrome-verification-of-our-operative-method-by-the-perioperative-course-of-esophageal-varices
#8
Yukio Kuniyoshi, Hitoshi Inafuku, Satoshi Yamashiro, Yuya Kise, Takaaki Nagano, Ryoko Arakaki, Tatsuya Maeda, Mizuki Ando, Shotaro Higa
OBJECTIVE: A total of 69 patients with Budd-Chiari syndrome (BCS) were operated by direct approach under cardiopulmonary bypass (CPB). To assess the operative procedure, the perioperative course of esophageal varices (EVs) was evaluated. PATIENTS AND METHODS: Of the 69 patients, 59 (22 females) were enrolled in this study because they had complete follow-up data for endoscopic evaluation of EVs. Their mean age was 46.3 ± 13.0 years (range 21-73.3 years). EVs were found in 52 patients...
August 21, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28805266/hypothermic-pulsatile-preservation-of-kidneys-from-uncontrolled-deceased-donors-after-cardiac-arrest-a-retrospective-study
#9
Xavier Matillon, Fabrice Danjou, Palmina Petruzzo, Olivier Thaunat, Thomas Rimmele, Claire Delsuc, Alexandre Faure, Maud Rabeyrin, Vannary Meas Yedid, William Hanf, Emmanuel Morelon, Lionel Badet, Ricardo Codas
Kidneys from uncontrolled donors after cardiac arrest (uDCD) suffer from a period of warm ischemia between cardiac arrest and cold flushing. Aim of the study was to evaluate renal outcomes of uDCD kidneys selected on the basis of renal Resistance Index (RI) and its influence on graft function and survival. The study included 44 kidneys procured from 26 uDCD starting 1.1.2006 until 12.31.2013. The donors (Maastricht category II) underwent cardiopulmonary resuscitation by assisted ventilation and chest compression; the organs were preserved with in situ cold perfusion or a normothermic regional perfusion...
August 14, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28793036/effect-of-mild-hypothermia-on-renal-ischemia-reperfusion-injury-after-cardiopulmonary-resuscitation-in-a-swine-model
#10
Wei Yuan, Jun-Yuan Wu, Yong-Zhen Zhao, Jie Li, Jie-Bin Li, Zhen-Hua Li, Chun-Sheng Li
Purpose: To investigate the effect of intravascular cooling on renal function after resuscitation. Methods: Twenty four pigs were randomized into three groups (n=8 in each group): therapeutic hypothermia group (TH group), normothermia group (NH group) and sham operation group (SHAM group). After 6 minutes of untreated VF, CPR was performed. Upon ROSC, the TH group received the intravascular cooling. The NH and SHAM group did not undergo therapeutic hypothermia. Haemodynamic parameters were recorded...
July 2017: Acta Cirúrgica Brasileira
https://www.readbyqxmd.com/read/28738010/effects-of-the-%C3%AE-2-adrenoceptor-agonist-medetomidine-on-the-distribution-and-clearance-of-alfaxalone-during-coadministration-by-constant-rate-infusion-in-dogs
#11
Rachel C Bennett, Kati M Salla, Marja R Raekallio, Mika Scheinin, Outi M Vainio
OBJECTIVE To assess the possible impact of medetomidine on concentrations of alfaxalone in plasma, when coadministered as a constant rate infusion (CRI) to dogs, and to determine the possible impact of medetomidine on the cardiopulmonary effects of alfaxalone during CRI. ANIMALS 8 healthy adult Beagles. PROCEDURES 3 treatments were administered in a randomized crossover design as follows: 1 = saline (0.9% NaCl) solution injection, followed in 10 minutes by induction of anesthesia with alfaxalone (loading dose, 2...
August 2017: American Journal of Veterinary Research
https://www.readbyqxmd.com/read/28708703/preparticipation-sports-physicals-a-comparison-of-single-provider-and-station-based-models
#12
David Lick, Karim Abdel-Aty, Daniel Diaz, Jaspaul Dulku, Sandeep Lochub, Kamran Mir, Robert Ricketts
BACKGROUND: Preparticipation physical examinations (PPEs) are required for children and adolescents before sports participation to identify at-risk athletes. These evaluations can be completed in a traditional office-based setting or in a station-based format. It is unclear if one format is superior to the other in identifying at-risk athletes. METHODS: We performed a retrospective chart review of children and adolescents between the ages 10 and 18 years who received their PPE in our office or in a station-based setting in a local high school between the years 2009 and 2015...
July 11, 2017: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
https://www.readbyqxmd.com/read/28649460/pulmonary-diseases-induced-by-ambient-ultrafine-and-engineered-nanoparticles-in-twenty-first-century
#13
Tian Xia, Yifang Zhu, Lina Mu, Zuo-Feng Zhang, Sijin Liu
Air pollution is a severe threat to public health globally, affecting everyone in developed and developing countries alike. Among different air pollutants, particulate matter (PM), particularly combustion-produced fine PM (PM2.5) has been shown to play a major role in inducing various adverse health effects. Strong associations have been demonstrated by epidemiological and toxicological studies between increases in PM2.5 concentrations and premature mortality, cardiopulmonary diseases, asthma and allergic sensitization, and lung cancer...
December 2016: National Science Review
https://www.readbyqxmd.com/read/28510738/pharmacokinetic-pharmacodynamic-model-for-unfractionated-heparin-dosing-during-cardiopulmonary-bypass
#14
X Delavenne, E Ollier, S Chollet, F Sandri, J Lanoiselée, S Hodin, A Montmartin, J-F Fuzellier, P Mismetti, L Gergelé
Background: High-dose heparin is used during cardiopulmonary bypass (CPB) to prevent thrombosis in the circuits used for extracorporeal circulation. The aim of this study was, initially, to develop a population pharmacokinetic/pharmacodynamic (PK/PD) model to assess the variability of PK/PD parameters and their correlation with the results of the routine haemostatic test activated clotting time (ACT) and thereafter to develop a Bayesian estimator enabling an individualized dosing strategy...
May 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28485317/early-kinetics-of-procalcitonin-in-predicting-surgical-outcomes-in-type-a-aortic-dissection-patients
#15
Hua Liu, Zhe Luo, Lan Liu, Xiao-Mei Yang, Ya-Min Zhuang, Ying Zhang, Guo-Wei Tu, Guo-Guang Ma, Guang-Wei Hao, Jian-Feng Luo, Ji-Li Zheng, Chun-Sheng Wang
BACKGROUND: In cardiac surgery, elevation of procalcitonin (PCT) could be observed postoperatively in the absence of any evidence of infection and also seems to be a prognostic marker. PCT levels measured in patients undergoing Type A aortic dissection (TAAD) were used to determine prognostic values for complications and surgical outcomes. METHODS: Measurements of PCT, C-reactive protein (CRP), and leukocyte count were observed in TAAD surgery patients (n = 251; average age: 49...
May 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28457076/improvement-in-creatinine-clearance-after-open-heart-surgery-in-infants-as-an-early-indicator-of-surgical-success
#16
Amit Dagan, Ovadia Dagan
BACKGROUND: Early surgical correction of congenital heart malformations in neonates and small infants may be complicated by acute kidney injury (AKI), which is associated with higher morbidity and mortality rates, especially in patients who require dialysis. Glomerular filtration rate (GFR) is considered the best measurement of renal function which, in neonates and infants, is highly dependent on heart function. OBJECTIVES: To determine whether measurements of creatinine clearance after open heart surgery in neonates and young infants can serve as an early indicator of surgical success or AKI...
December 2016: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/28456134/improvement-in-baroreflex-control-of-renal-sympathetic-nerve-activity-in-obese-sprague-dawley-rats-following-immunosuppression
#17
S A Khan, M Z A Sattar, N A Abdullah, H A Rathore, A Ahmad, M H Abdulla, E J Johns
AIM: This investigation explored the hypothesis that in obesity an inflammatory response in the kidney contributed to a renal nerve-dependent blunting of the baroreflex regulation of renal sympathetic nerve activity. METHODS: Rats received a normal (12% kcal) or high-fat (45% kcal) diet for 8 weeks plus daily injections of vehicle (0.9% NaCl i.p) or tacrolimus (0.25 mg kg(-1) day(-1) i.p) from weeks 3-8. Following anaesthesia, left renal sympathetic nerve activity was recorded, baroreflex gain curves were generated, by infusing phenylephrine and sodium nitroprusside, and cardiopulmonary baroreceptors challenged by infusing a saline load...
April 29, 2017: Acta Physiologica
https://www.readbyqxmd.com/read/28444697/population-pharmacokinetics-of-dexmedetomidine-in-infants
#18
Rachel G Greenberg, Huali Wu, Matthew Laughon, Edmund Capparelli, Stevie Rowe, Kanecia O Zimmerman, P Brian Smith, Michael Cohen-Wolkowiez
Despite limited pharmacokinetic (PK) data, dexmedetomidine is increasingly being used off-label for sedation in infants. We aimed to characterize the developmental PK changes of dexmedetomidine during infancy. In this open-label, single-center PK study of dexmedetomidine in infants receiving dexmedetomidine per clinical care, ≤10 blood samples per infant were collected. A set of structural PK models and residual error models were explored using nonlinear mixed-effects modeling in NONMEM. Covariates including postmenstrual age (PMA), serum creatinine, and recent history of cardiac surgery requiring cardiopulmonary bypass were investigated for their influence on PK parameters...
September 2017: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28396605/bypassing-adverse-injection-reactions-to-nanoparticles-through-shape-modification-and-attachment-to-erythrocytes
#19
Peter Popp Wibroe, Aaron C Anselmo, Per H Nilsson, Apoorva Sarode, Vivek Gupta, Rudolf Urbanics, Janos Szebeni, Alan Christy Hunter, Samir Mitragotri, Tom Eirik Mollnes, Seyed Moein Moghimi
Intravenously injected nanopharmaceuticals, including PEGylated nanoparticles, induce adverse cardiopulmonary reactions in sensitive human subjects, and these reactions are highly reproducible in pigs. Although the underlying mechanisms are poorly understood, roles for both the complement system and reactive macrophages have been implicated. Here, we show the dominance and importance of robust pulmonary intravascular macrophage clearance of nanoparticles in mediating adverse cardiopulmonary distress in pigs irrespective of complement activation...
July 2017: Nature Nanotechnology
https://www.readbyqxmd.com/read/28325788/decompression-illness-with-hypovolemic-shock-and-neurological-failure-symptoms-after-two-risky-dives-a-case-report
#20
Sebastian Klapa, Johannes Meyne, Wataru Kähler, Frauke Tillmans, Henning Werr, Andreas Binder, Andreas Koch
Hypovolemia is known to be a predisposing factor of decompression illness (DCI) while diving. The typical clinically impressive neurological symptoms of DCI may distract from other symptoms such as an incipient hypovolemic shock. We report the case of a 61-year-old male Caucasian, who presented with an increasing central and peripheral neural failure syndrome and massive hypovolemia after two risky dives. Computed tomography (CT) scans of the chest and Magnetic resonance imaging scans of the head revealed multiple cerebral and pulmonary thromboembolisms...
March 2017: Physiological Reports
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