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https://www.readbyqxmd.com/read/28208488/analysis-of-flame-acceleration-in-open-or-vented-obstructed-pipes
#1
Vitaly Bychkov, Jad Sadek, V'yacheslav Akkerman
While flame propagation through obstacles is often associated with turbulence and/or shocks, Bychkov et al. [V. Bychkov et al., Phys. Rev. Lett. 101, 164501 (2008)10.1103/PhysRevLett.101.164501] have revealed a shockless, conceptually laminar mechanism of extremely fast flame acceleration in semiopen obstructed pipes (one end of a pipe is closed; a flame is ignited at the closed end and propagates towards the open one). The acceleration is devoted to a powerful jet flow produced by delayed combustion in the spaces between the obstacles, with turbulence playing only a supplementary role in this process...
January 2017: Physical Review. E
https://www.readbyqxmd.com/read/28196019/pancreatoscopy-directed-electrohydraulic-lithotripsy-for-pancreatic-ductal-stones-in-painful-chronic-pancreatitis-using-spyglass
#2
Noor L H Bekkali, Sam Murray, Gavin J Johnson, Steven Bandula, Zahir Amin, Michael H Chapman, Stephen P Pereira, George J M Webster
OBJECTIVE: Painful chronic pancreatitis is often associated with main duct obstruction due to stones. Approaches to management are challenging, including surgery, extracorporeal shock wave lithotripsy, or endoscopic approaches. Here, we report our experience of pancreatoscopy + electrohydraulic lithotripsy (EHL) for pancreatic duct (PD) stones using SpyGlass. METHODS: We retrospectively audited the use of SpyGlass (Legacy and DS) + EHL. Indication, procedural details, and clinical outcomes were assessed...
February 14, 2017: Pancreas
https://www.readbyqxmd.com/read/28168570/early-enteral-nutrition-in-critically-ill-patients-esicm-clinical-practice-guidelines
#3
REVIEW
Annika Reintam Blaser, Joel Starkopf, Waleed Alhazzani, Mette M Berger, Michael P Casaer, Adam M Deane, Sonja Fruhwald, Michael Hiesmayr, Carole Ichai, Stephan M Jakob, Cecilia I Loudet, Manu L N G Malbrain, Juan C Montejo González, Catherine Paugam-Burtz, Martijn Poeze, Jean-Charles Preiser, Pierre Singer, Arthur R H van Zanten, Jan De Waele, Julia Wendon, Jan Wernerman, Tony Whitehouse, Alexander Wilmer, Heleen M Oudemans-van Straaten
PURPOSE: To provide evidence-based guidelines for early enteral nutrition (EEN) during critical illness. METHODS: We aimed to compare EEN vs. early parenteral nutrition (PN) and vs. delayed EN. We defined "early" EN as EN started within 48 h independent of type or amount. We listed, a priori, conditions in which EN is often delayed, and performed systematic reviews in 24 such subtopics. If sufficient evidence was available, we performed meta-analyses; if not, we qualitatively summarized the evidence and based our recommendations on expert opinion...
February 6, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28148323/primary-care-management-of-patients-with-coarctation-of-the-aorta
#4
REVIEW
Jeffrey R Boris
Coarctation of the aorta is a congenital cardiac defect that results in a variable degree of obstruction to the left side of the heart. It can present with either acute shock in the neonatal period as a critical lesion or it can appear more insidiously with hypertension or other findings later in life. This article summarises aspects of outpatient care of patients with this lesion, including clinical history and physical examination, ancillary testing, and issues associated with long-term follow-up and management...
December 2016: Cardiology in the Young
https://www.readbyqxmd.com/read/28135411/use-of-cryopoor-plasma-for-albumin-replacement-and-continuous-antimicrobial-infusion-for-treatment-of-septic-peritonitis-in-a-dog
#5
Meaghan K Ropski, Julien Guillaumin, Andrea A Monnig, Katy Townsend, Mary A McLoughlin
OBJECTIVE: To report the successful management of a dog with septic peritonitis and septic shock secondary to enterectomy dehiscence using novel techniques for identification of intestinal dehiscence and for septic shock treatment. CASE SUMMARY: A 5-year-old castrated male Bernese Mountain Dog presented for lethargy 6 days following enterotomy for foreign body obstruction. Septic peritonitis was identified due to dehiscence of the enterotomy site, and resection and anastomosis were performed using a gastrointestinal anastomosis and thoracoabdominal stapling device...
January 30, 2017: Journal of Veterinary Emergency and Critical Care
https://www.readbyqxmd.com/read/28127711/how-to-manage-tension-gastrothorax-a-case-report-of-tension-gastrothorax-with-multiple-trauma-due-to-traumatic-diaphragmatic-rupture
#6
Naofumi Bunya, Keigo Sawamoto, Shuji Uemura, Takashi Toyohara, Yukino Mori, Ryoko Kyan, Kei Miyata, Hideto Irifune, Keisuke Harada, Eichi Narimatsu
BACKGROUND: Tension gastrothorax is a kind of obstructive shock with prolapse and distention of the stomach into the thoracic cavity. Progressive gastric distension leads to mediastinal shift, reduced venous return, decreased cardiac output, and ultimately cardiac arrest. Therefore, it is crucial to decompress the stomach distension for the initial resuscitation of tension gastrothorax. CASE PRESENTATION: A 75-year-old female was transported to our resuscitation bay due to motor vehicle crash...
December 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28120291/role-of-shsps-in-organizing-cytosolic-protein-aggregation-and-disaggregation
#7
REVIEW
Axel Mogk, Bernd Bukau
Small heat shock proteins (sHsps) exhibit an ATP-independent chaperone activity to prevent the aggregation of misfolded proteins in vitro. The seemingly conflicting presence of sHsps in insoluble protein aggregates in cells obstructs a precise definition of sHsp function in proteostasis networks. Recent findings specify sHsp activities in protein quality control systems. The sHsps of yeast, Hsp42 and Hsp26, interact with early unfolding intermediates of substrates, keeping them in a ready-to-refold conformation close to the native state...
January 24, 2017: Cell Stress & Chaperones
https://www.readbyqxmd.com/read/28115289/profibrotic-ihg-1-complexes-with-renal-disease-associated-hspa5-and-trap1-in-mitochondria
#8
Una Bhreathnach, Brenda Griffin, Eoin Brennan, Leah Ewart, Debra Higgins, Madeline Murphy
The highly conserved mitochondrial protein induced in high glucose-1 (IHG-1) functions to maintain mitochondrial quality and is associated with the development of fibrosis in diabetic nephropathy. Towards identifying novel approaches to treating diabetic kidney disease, IHG-1-protein-protein interactions were investigated using epitope-tagged immunoprecipitation analyses followed by mass spectrometry. Here we show that IHG-1 is solely expressed in mitochondria and localised to the inner mitochondrial membrane, the region where mitochondrial reactive oxygen species are generated...
January 20, 2017: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/28112690/assessment-of-oxidative-stress-markers-and-hearing-thresholds-in-patients-with-obstructive-sleep-apnea-hypopnoea-treated-with-cysteine-and-superoxide-dismutase-therapy
#9
Agostino Serra, Luigi Maiolino, Salvatore Cocuzza, Milena Di Luca, Gianluca Campione, Luisa Licciardello, Paola Di Mauro
BACKGROUND AND AIM OF THE WORK: In OSAHS, the hypoxia and reoxygenation cicles, maintain a state of oxidative stress, which seems to cause a change in the oxidative balance. Our aim is to compare the markers of oxidative stress with audiological findings and OSAHS severity, in OSAHS patients untreated and also treated ones, with cysteine and superoxide dismutase. METHODS: 65 patients (42 Men, 23 Women) with 30-65 years age range have been enrolled, with a mean age of 52...
January 16, 2017: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/28072930/left-ventricular-outflow-tract-obstruction-be-prepared
#10
J S Evans, S J Huang, A S McLean, M Nalos
The current trend to treat hypotension in critically ill patients is to place a greater emphasis on inotropic support and less on fluid resuscitation in order to limit the potential harm from fluid overload. This combination may trigger left ventricular outflow tract obstruction (LVOTO) in susceptible patients. Although LVOTO is classically described in patients with hypertrophic cardiomyopathy it has been reported in other conditions including septic shock, apical ballooning syndrome, myocardial infarction, respiratory failure, and post valvular surgery...
January 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28054280/successful-bypass-operation-for-esophageal-obstruction-after-acute-esophageal-necrosis-a-case-report
#11
Yayoi Sakatoku, Masahide Fukaya, Kazushi Miyata, Masato Nagino
BACKGROUND: Acute esophageal necrosis (AEN) is a rare clinical disorder. Esophageal stenosis or obstruction is one of severe complications, but there are a few reports about surgical treatments. In such a situation, it still remains controversial which to choose, esophagectomy or bypass operation. CASE PRESENTATION: A 61-year-old woman was admitted to the local hospital for septic shock with diabetic ketoacidosis due to necrotizing fasciitis of the right thigh. Three days later, she had hematemesis, and gastrointestinal endoscopy revealed black mucosal coloration throughout the entire esophagus...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28034568/efficacy-and-safety-of-balloon-pulmonary-angioplasty-for-chronic-thromboembolic-pulmonary-hypertension-guided-by-cone-beam-computed-tomography-and-electrocardiogram-gated-area-detector-computed-tomography
#12
Takeshi Ogo, Tetsuya Fukuda, Akihiro Tsuji, Shigefumi Fukui, Jin Ueda, Yoshihiro Sanda, Yoshiaki Morita, Ryotaro Asano, Nao Konagai, Satoshi Yasuda
BACKGROUND: Chronic thromboembolic pulmonary hypertension (CTEPH) is a disease characterized by chronic obstructive thrombus and pulmonary hypertension. Balloon pulmonary angioplasty (BPA), an emerging alternative catheter-based treatment for inoperable patients with CTEPH, has not yet been standardised, especially for lesion assessment in distal pulmonary arteries. Recent advancement in computed tomography enables distal CTEPH lesions to be visualized. METHODS: We retrospectively studied 80 consecutive patients with inoperable CTEPH who received BPA guided by cone-beam computed tomography (CT) (CBCT) or electrocardiogram (ECG)-gated area detector CT (ADCT) for target lesion assessment...
December 21, 2016: European Journal of Radiology
https://www.readbyqxmd.com/read/28011405/platelet-to-lymphocyte-ratio-as-a-novel-marker-of-in-hospital-and-long-term-adverse-outcomes-among-patients-with-acute-pulmonary-embolism-a-single-center-large-scale-study
#13
Elif Hande Ozcan Cetin, Mehmet Serkan Cetin, Ugur Canpolat, Ahmet Akdi, Dursun Aras, Ahmet Temizhan, Sinan Aydogdu
BACKGROUND: The interaction of platelets with leukocytes is a well-known process both in progression and prognosis of acute pulmonary embolism (PE). Recently, platelet to lymphocyte ratio (PLR) is emerged as an indirect inflammatory indicator which was shown to be associated with adverse cardiovascular events in various clinical conditions, including acute PE. However, the long-term prognostic value of PLR in acute PE has not been investigated thoroughly. Therefore, we aimed to assess the impact of PLR on both in-hospital and long-term adverse outcomes in acute PE...
February 2017: Thrombosis Research
https://www.readbyqxmd.com/read/27988252/airway-and-circulatory-collapse-due-to-retropharyngeal-hematoma-after-blunt-vertebral-artery-injury
#14
Shunsuke Kudo, Kazuyuki Fukushima, Motonori Hashimoto, Masayuki Furutake, Keiji Tanaka, Kunihiko Okada
Retropharyngeal hematoma following blunt cervical spine injury is a known cause of airway obstruction, but it is not known to cause hemorrhagic shock. We report the case of a massive retropharyngeal hematoma caused by a blunt vertebral artery transection leading simultaneously to airway obstruction and hemorrhagic shock. An 83-year-old woman was injured in a motorcycle accident. In the field, the patient exhibited paradoxical breathing with no breath sounds, and her blood pressure could not be measured. Therefore, emergency intubation and fluid resuscitation were initiated and the patient was transferred to the emergency department...
December 9, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27984523/etiology-of-shock-in-the-emergency-department-a-12-year-population-based-cohort-study
#15
Jon Gitz Holler, Helene Kildegaard Jensen, Daniel Pilsgaard Henriksen, Lars Melholt Rasmussen, Søren Mikkelsen, Court Pedersen, Annmarie Touborg Lassen
INTRODUCTION: The knowledge of the etiology and associated mortality of undifferentiated shock in the emergency department (ED) is limited. We aimed to describe the etiology based proportions and incidence rates (IR) of shock, as well as the associated mortality in the ED. METHODS: Population-based cohort study at an University Hospital ED in Denmark from January 1, 2000, to December 31, 2011. Patients aged ≥18 years living in the ED-catchment area (N = 225,000) with a first time ED presentation with shock (n = 1,646) defined as hypotension (systolic blood pressure ≤100 mmHg)) and ≥1 organ failures were included...
December 14, 2016: Shock
https://www.readbyqxmd.com/read/27983541/effect-of-increasing-mean-arterial-blood-pressure-on-microcirculation-in-patients-with-cardiogenic-shock-supported-by-extracorporeal-membrane-oxygenation
#16
Zhongtao Du, Zaishen Jia, Jinhong Wang, Zhichen Xing, Chunjing Jiang, Bo Xu, Xiaofang Yang, Feng Yang, Na Miao, Jialin Xing, Hong Wang, Ming Jia, Xiaotong Hou
BACKGROUND: Little is known about the effect of mean arterial blood pressure (MAP) augmentation on the microcirculation in cardiogenic-shock patients with peripheral veno-arterial extracorporeal membrane oxygenation (ECMO) support. We investigated the effect of increasing MAP on the microcirculation in cardiogenic-shock patients with ECMO support. METHODS: A single-center prospective observational study under taken in ICU patients undergoing ECMO support for post-cardiotomy cardiogenic shock was carried out...
December 14, 2016: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/27928224/clinical-outcomes-of-elderly-south-east-asian-patients-in-primary-percutaneous-coronary-intervention-for-st-elevation-myocardial-infarction
#17
Jieli Tong, Wen Wei Xiang, An Shing Ang, Wen Jun Sim, Kien Hong Quah, David Foo, Paul Jau Lueng Ong, Hee Hwa Ho
OBJECTIVE: To evaluate the clinical characteristics and in-hospital outcomes of elderly South-East Asian patients undergoing primary percutaneous coronary intervention (PPCI). METHODS: From January 2009 to December 2012, 1268 patients (86.4% male, mean age of 58.4 ± 12.2 years) presented to our hospital for ST-elevation myocardial infarction (STEMI) and underwent PPCI. They were divided into two groups: elderly group defined as age ≥ 70 years and non-elderly group defined as age < 70 years...
October 2016: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/27904102/manifestation-of-latent-left-ventricular-outflow-tract-obstruction-in-the-acute-phase-of-takotsubo-cardiomyopathy
#18
Kazuyuki Ozaki, Takeshi Okubo, Komei Tanaka, Yukio Hosaka, Keiichi Tsuchida, Kazuyoshi Takahashi, Hirotaka Oda, Tohru Minamino
Objective Left ventricular outflow tract (LVOT) obstruction is a complication in 15-25% of patients with Takotsubo cardiomyopathy and sometimes leads to catastrophic outcomes, such as cardiogenic shock or cardiac rupture. However, the underlying mechanisms have not been clarified. Methods and Results We experienced 22 cases of Takotsubo cardiomyopathy during 3 years, and 4 of these 22 cases were complicated with LVOT obstruction in the acute phase (mean age 79±5 years, 1 man, 21 women). The LVOT pressure gradient in the acute phase was 100±17 mmHg...
2016: Internal Medicine
https://www.readbyqxmd.com/read/27887016/inferior-vena-caval-filter-strut-perforation-causing-intramural-duodenal-haematoma
#19
Zoheb Berry Williams, Nicole M Organ, Stephen Deane
We present a case of intramural duodenal haematoma caused by inferior vena caval (IVC) filter strut perforation requiring innovative open and endovascular retrieval. A 32-year-old woman presents in shock with dull epigastric pain and non-bilious vomiting. She had previously had an IVC filter for deep venous thrombosis and pulmonary embolism. Computed tomography demonstrated strut perforation into the second part of the duodenum, causing intramural haematoma and duodenal obstruction. Laparotomy facilitated evacuation of the duodenal haematoma, while the IVC filter was retrieved by endovascular means...
November 24, 2016: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/27884304/a-remedy-for-kidney-disease-successfully-alters-the-cold-shock-protein-response-during%C3%A2-inflammation
#20
Sabine Brandt, Peter R Mertens
Kidneys undergoing acute inflammatory responses are characterized by cell infiltration and a cytokinergic milieu. The hazard resides in the perpetuation of inflammation and ensuing fibrosis. In this issue of Kidney International, Wang et al.(4) identify the cold shock Y-box binding protein-1 as the key orchestrator of cell infiltration in experimental tubulointerstitial nephritis following ureteral obstruction. Intriguingly, a small molecule previously designed to interfere with Y-box binding protein-1 interactions mediates an anti-inflammatory response and halts fibrogenesis...
December 2016: Kidney International
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