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https://www.readbyqxmd.com/read/29441350/perioperative-goal-directed-therapy-using-invasive-uncalibrated-pulse-contour-analysis
#1
Bernd Saugel, Daniel A Reuter
"Perioperative goal-directed therapy" (PGDT) aims at an optimization of basic and advanced global hemodynamic variables to maintain adequate oxygen delivery to the end-organs. PGDT protocols help to titrate fluids, vasopressors, or inotropes to hemodynamic target values. There is considerable evidence that PGDT can improve patient outcome in high-risk patients if both fluids and inotropes are administered to target hemodynamic variables reflecting blood flow. Despite this evidence, PGDT strategies aiming at an optimization of blood flow seem to be not well implemented in routine clinical care...
2018: Frontiers in Medicine
https://www.readbyqxmd.com/read/29430404/spectrum-of-cardiac-manifestations-and-its-relationship-to-outcomes-in-patients-admitted-with-scrub-typhus-infection
#2
Gunasekaran Karthik, Thomas Isaiah Sudarsan, John Victor Peter, Thambu Sudarsanam, George M Varghese, Paul Kundavaram, Sowmya Sathyendra, Ramya Iyyadurai, Kishore Pichamuthu
AIM: To study the spectrum of cardiac manifestations in scrub typhus infection and assess its relationship to outcomes. METHODS: Demographic data, electrocardiographic (ECG) changes, left ventricular (LV) systolic and diastolic function, myocardial injury (defined as troponin T > 14 pg/mL), and pericardial effusion were documented. Myocarditis was diagnosed when myocardial injury was associated with global LV systolic dysfunction. The relationship between myocarditis and outcomes was assessed using logistic regression analysis and expressed as odds ratio (OR) with 95%CI...
February 4, 2018: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29429457/-association-between-vasoactive-inotropic-score-and-prognosis-in-children-with-septic-shock
#3
Yan-Ran Qin, Cheng-Jun Liu, Feng Xu, Jing Li, Xiao-Yu Xiong
OBJECTIVE: To investigate the association between vasoactive-inotropic score (VIS) and prognosis in children with septic shock. METHODS: A total of 117 children with decompensated septic shock who received the treatment with vasoactive agents were enrolled. According to their prognosis, they were divided into death group with 41 children and survival group with 76 children. With the maximum VIS within the first 24 hours (24hVIS max) as the cut-off value (29.5), the children were divided into low VIS group with 78 children and high VIS group with 39 children...
February 2018: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/29426683/cardiothoracic-mri-in-the-icu-a-10-year-experience
#4
Narmadan Kumarasamy, Nima Tishbi, Shey Mukundan, Ariel Shiloh, Jeffrey M Levsky, Linda B Haramati
RATIONALE AND OBJECTIVE: The objective of this study was to identify the feasibility and pitfalls of cardiothoracic magnetic resonance imaging (MRI) in intensive care unit (ICU) patients. MATERIALS AND METHODS: This retrospective study identified adult ICU patients scheduled for cardiothoracic MRIs during a 10-year study period. ICU patients scheduled for brain MRIs served as a comparison group. A chart review was performed to identify factors impacting a patient's ability to undergo an MRI...
February 6, 2018: Academic Radiology
https://www.readbyqxmd.com/read/29417757/natriuretic-peptide-receptor-c-mediated-attenuation-of-vascular-smooth-muscle-cell-hypertrophy-involves-gq%C3%AE-plc%C3%AE-1-proteins-and-ros-associated-signaling
#5
Ashish Jain, Madhu B Anand-Srivastava
Hypertension is associated with vascular remodeling due to hyperproliferation and hypertrophy of vascular smooth muscle cells (VSMC). Recently, we showed the implication of enhanced expression of Gqα and PLCβ1 proteins in hypertrophy of VSMCs from 16-week-old spontaneously hypertensive rats (SHR). The aim of this study was to investigate whether C-ANP4-23 , a natriuretic peptide receptor-C (NPR-C) ligand that was shown to inhibit vasoactive peptide-induced enhanced protein synthesis in A10 VSMC could also attenuate hypertrophy of VSMC isolated from rat model of cardiac hypertrophy and to further explore the possible involvement of Gqα/PLCβ1 proteins and ROS-mediated signaling in this effect...
February 2018: Pharmacology Research & Perspectives
https://www.readbyqxmd.com/read/29395173/the-sensitivity-of-clinician-diagnosis-of-sepsis-in-tertiary-and-community-based-emergency-settings
#6
Halden F Scott, Emily E Greenwald, Lalit Bajaj, Sara J Deakyne Davies, Lina Brou, Allison Kempe
OBJECTIVES: To assess whether the risk of missed clinician diagnosis of pediatric sepsis requiring care in the intensive care unit (ICU) was greater in community vs tertiary pediatric emergency care settings with sepsis pathways. STUDY DESIGN: An observational cohort study in a tertiary pediatric emergency department (ED) staffed by pediatric emergency physicians and 4 affiliated community pediatric ED/urgent care sites staffed by general pediatricians. Use of an institutional sepsis order set or pathway was considered clinician diagnosis of sepsis...
January 25, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29382081/n-salicyloyltryptamine-an-n-benzoyltryptamine-analogue-induces-vasorelaxation-through-activation-of-the-no-sgc-pathway-and-reduction-of-calcium-influx
#7
Robson Cavalcante Veras, Darizy Flávia Silva, Lorena Soares Bezerra, Valéria Lopes de Assis, Walma Pereira de Vasconcelos, Maria do Carmo Alustau, José George Ferreira de Albuquerque, Fabíola Fialho Furtado, Islania Giselia de Albuquerque Araújo, Fátima de Lourdes Assunção Araújo de Azevedo, Thais Porto Ribeiro, José Maria Barbosa-Filho, Stanley Juan Chavez Gutierrez, Isac Almeida Medeiros
Benzoyltryptamine analogues act as neuroprotective and spasmolytic agents on smooth muscles. In this study, we investigated the ability of N-salicyloyltryptamine (STP) to produce vasorelaxation and determined its underlying mechanisms of action. Isolated rat mesenteric arteries with and without functional endothelium were studied in an isometric contraction system in the presence or absence of pharmacological inhibitors. Amperometric experiments were used to measure the nitric oxide (NO) levels in CD31+ cells using flow cytometry...
January 28, 2018: Molecules: a Journal of Synthetic Chemistry and Natural Product Chemistry
https://www.readbyqxmd.com/read/29336942/malleable-penile-implant-is-an-effective-therapeutic-option-in-men-with-peyronie-s-disease-and-erectile-dysfunction
#8
Mohamad Habous, Alaa Tealab, Mohammed Farag, Tarek Soliman, Ben Williamson, Saad Mahmoud, Amin Elserafy, Zenhom Mekawi, Abdallah Remeah, Mohammed Nassar, Osama Laban, Osama Abdelwahab, Saleh Binsaleh, Simone Giona, David Ralph, John Mulhall
BACKGROUND: The inflatable penile prosthesis (IPP) is typically the preferred implant for Peyronie's disease (PD) and malleable penile prostheses (MPPs) have been discouraged. AIMS: To evaluate the effectiveness and patient satisfaction of the MPP vs IPP in patients with PD. METHODS: Men with PD and erectile dysfunction who elected for penile implant surgery constituted the study population. Preoperatively, demographic and comorbidity parameters were recorded...
January 11, 2018: Sexual Medicine
https://www.readbyqxmd.com/read/29328496/hypotension-risk-based-on-vasoactive-agent-discontinuation-order-in-patients-in-the-recovery-phase-of-septic-shock
#9
Gretchen L Sacha, Simon W Lam, Abhijit Duggal, Heather Torbic, Anita J Reddy, Seth R Bauer
STUDY OBJECTIVES: Patients with septic shock often require vasoactive agents for hemodynamic support; however, the optimal approach to discontinuing these agents once patients reach the recovery phase is currently unknown. The objective of this evaluation was to compare the incidence of hypotension within 24 hours based on the discontinuation order of norepinephrine (NE) and vasopressin (AVP) in patients in the recovery phase of septic shock. DESIGN: Retrospective cohort study...
January 12, 2018: Pharmacotherapy
https://www.readbyqxmd.com/read/29285425/active-maintenance-of-endothelial-cells-prevents-kidney-fibrosis
#10
Seung Hee Yang, Yong Chul Kim, Jung Nam An, Jin Hyuk Kim, Juhoh Lee, Hee-Yoon Lee, Joo-Youn Cho, Jin Ho Paik, Yun Kyu Oh, Chun Soo Lim, Yon Su Kim, Jung Pyo Lee
Background: Soluble epoxide hydrolase (sEH) expressed by endothelial cells catalyzes the metabolism of epoxyeicosatrienoic acids (EETs), which are vasoactive agents. Methods: We used a unilateral ureteral obstruction mouse model of kidney fibrosis to determine whether inhibition of sEH activity reduces fibrosis, the final common pathway for chronic kidney disease. Results: sEH activity was inhibited by continuous release of the inhibitor 12-(3-adamantan-1-ylureido)-dodecanoic acid (AUDA) for 1 or 2 weeks...
December 2017: Kidney Research and Clinical Practice
https://www.readbyqxmd.com/read/29229261/preliminary-experience-in-combined-somatic-and-cerebral-oximetry-monitoring-in-liver-transplantation
#11
Tina Hu, Yves Collin, Réal Lapointe, François Martin Carrier, Luc Massicotte, Annik Fortier, Jean Lambert, Franck Vandenbroucke-Menu, André Y Denault
OBJECTIVE: The use of cerebral near-infrared spectroscopy (NIRS) has become widespread in cardiac surgery after research demonstrated an association between perioperative cerebral desaturations and postoperative complications. Somatic NIRS desaturation also is associated with an increased risk of postoperative complications and mortality. The objective of this study was to explore the trends of both somatic and cerebral NIRS during liver transplantation. DESIGN: A prospective, single-site, observational case series...
July 20, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29216944/-prognostic-value-of-oxygen-challenge-test-for-patients-with-cardiogenic-shock-receiving-extracorporeal-membrane-oxygenation
#12
Liang Dong, Xiuhong Zhang, Fengming Liang, Xuan Yu, Ting Yang, Lang Li
OBJECTIVE: To investigate the prognostic value of oxygen challenge test (OCT) for patients with cardiogenic shock receiving extracorporeal membrane oxygenation (ECMO). METHODS: A retrospective analysis was conducted. Seventy-eight patients diagnosed with cardiogenic shock receiving veno-arterial (V-A) ECMO admitted to Department of intensive care unit (ICU) of Wuxi People's Hospital Affiliated to Nanjing Medical University from June 2012 to May 2017 were enrolled...
December 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29151002/management-of-arrhythmia-in-sepsis-and-septic-shock
#13
Martin Balik, Vojtech Matousek, Michal Maly, Tomas Brozek
The occurrence of supraventricular arrhythmias is associated with an unfavourable prognosis in septic shock. Available trials are difficult to apply in sepsis and septic shock patients due to included cohorts, control groups and because "one size does not fit all". The priorities in the critically ill are maintenance of a sinus rhythm and diastolic ventricular filling. The rate control modality should be reserved for chronic AF and in situations when a sinus rhythm is difficult to maintain due to extreme stress conditions resulting from a high dosage of vasoactive agents...
November 18, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29135962/design-recombinant-fusion-expression-and-biological-evaluation-of-vasoactive-intestinal-peptide-analogue-as-novel-antimicrobial-agent
#14
Chunlan Xu, Yu Guo, Xiangjin Qiao, Xiaoya Shang, Weining Niu, Mingliang Jin
Antimicrobial peptides represent an emerging category of therapeutic agents with remarkable structural and functional diversity. Modified vasoactive intestinal peptide (VIP) (VIP analogue 8 with amino acid sequence "FTANYTRLRRQLAVRRYLAAILGRR") without haemolytic activity and cytotoxicity displayed enhanced antimicrobial activities against Staphylococcus aureus (S. aureus) ATCC 25923 and Escherichia coli (E. coli) ATCC 25922 than parent VIP even in the presence of 180 mM NaCl or 50 mM MgCl₂, or in the range of pH 4-10...
November 14, 2017: Molecules: a Journal of Synthetic Chemistry and Natural Product Chemistry
https://www.readbyqxmd.com/read/29135932/extracts-of-crataegus-oxyacantha-and-rosmarinus-officinalis-attenuate-ischemic-myocardial-damage-by-decreasing-oxidative-stress-and-regulating-the-production-of-cardiac-vasoactive-agents
#15
Raúl Enrique Cuevas-Durán, Juan Carlos Medrano-Rodríguez, María Sánchez-Aguilar, Elizabeth Soria-Castro, María Esther Rubio-Ruíz, Leonardo Del Valle-Mondragón, Alicia Sánchez-Mendoza, Juan Carlos Torres-Narvaéz, Gustavo Pastelín-Hernández, Luz Ibarra-Lara
Numerous studies have supported a role for oxidative stress in the development of ischemic damage and endothelial dysfunction. Crataegus oxyacantha (Co) and Rosmarinus officinalis (Ro) extracts are polyphenolic-rich compounds that have proven to be efficient in the treatment of cardiovascular diseases. We studied the effect of extracts from Co and Ro on the myocardial damage associated with the oxidative status and to the production of different vasoactive agents. Rats were assigned to the following groups: (a) sham; (b) vehicle-treated myocardial infarction (MI) (MI-V); (c) Ro extract-treated myocardial infarction (MI-Ro); (d) Co extract-treated myocardial infarction (MI-Co); or (e) Ro+Co-treated myocardial infarction (MI-Ro+Co)...
November 14, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29113858/differences-in-blood-pressure-by-measurement-technique-in-neurocritically-ill-patients-a-technological-assessment
#16
Abhijit V Lele, Daren Wilson, Prabhakar Chalise, Jules Nazzaro, Vijay Krishnamoorthy, Monica S Vavilala
Blood pressure data may vary by measurement technique. We performed a technological assessment of differences in blood pressure measurement between non-invasive blood pressure (NIBP) and invasive arterial blood pressure (ABP) in neurocritically ill patients. After IRB approval, a prospective observational study was performed to study differences in systolic blood pressure (SBP), mean arterial pressure (MAP), and cerebral perfusion pressure (CPP) values measured by NIBP arm, ABP at level of the phlebostatic axis (ABP heart) and ABP at level of the external auditory meatus (ABP brain) at 30 and 45-degree head of bed elevation (HOB) using repeated measure analysis of covariance and correlation coefficients...
January 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29112184/insulin-like-growth-factor-system-in-remission-and-flare-of-inflammatory-bowel-diseases
#17
Małgorzata Krakowska-Stasiak, Dorota Cibor, Renata Domagała-Rodacka, Kinga Sałapa, Katarzyna Szczeklik, Danuta Owczarek
INTRODUCTION    Insulin-like growth factor-1 (IGF-1) is involved in the modulation of immunity and inflammation. It also plays a role in regulating the migration of endothelial cells and production of vasoactive agents.  OBJECTIVES    This study assessed IGF-1 and insulin-like growth factor bind protein-3 (IGFBP-3) concentrations and their relationships to disease activity in patients with inflammatory bowel disease (IBD). PATIENTS AND METHODS    A total of 129 adult patients with IBD (69 with Crohn's disease [CD] and 60 with ulcerative colitis [UC]) were involved in the study...
November 3, 2017: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/29104721/topical-a-agonist-therapy-for-persistent-facial-erythema-of-rosacea-and-the-addition-of-oxmetazoline-to-the-treatment-armamentarium-where-are-we-now
#18
REVIEW
James Q Del Rosso
The presence of vasoactivity in rosacea-affected skin led to the development of two topical α-adrenergic receptor agonists, brimonidine tartrate 0.5% gel and oxymetazoline hydrochloride 1% cream, both approved by the United States Food and Drug Administration for treatment of persistent facial erythema of rosacea. In this article, the author discusses challenges related to the treatment of persistent facial erythema of rosacea and the use of a-agonist therapy. The author also discusses cases of worsening of facial erythema after the application of brimonidine, as well as briefly reviews recently reported clinical data on oxymetazoline...
July 2017: Journal of Clinical and Aesthetic Dermatology
https://www.readbyqxmd.com/read/29101165/myocardial-contrast-echocardiography-in-mice-technical-and-physiological-aspects
#19
Melissa Verkaik, Erik van Poelgeest, Rick F J Kwekkeboom, Piet M Ter Wee, Charissa E van den Brom, Marc G Vervloet, Etto C Eringa
Myocardial contrast echocardiography (MCE) offers the opportunity to study myocardial perfusion defects in mice in detail. The value of MCE compared to SPECT, PET and CT consists of high spatial resolution, the possibility of quantification of blood volume and relatively low costs. Nevertheless, a number of technical and physiological aspects should be considered to ensure reproducibility among research groups. The aim of this overview is to describe technical aspects of MCE and the physiological parameters that influence myocardial perfusion data obtained with this technique...
November 3, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/29098094/severe-undifferentiated-vasoplegic-shock-refractory-to-vasoactive-agents-treated-with-methylene-blue
#20
Farheen Manji, Benjamin Wierstra, Juan Posadas
Methylene blue is a phenothiazine-related heterocyclic aromatic molecule presently used in the treatment of methemoglobinemia. Recently, it has been implicated in the treatment of severe refractory vasoplegic shock caused by anaphylaxis, sepsis, or postcardiopulmonary bypass. We present a case of a 27-year-old male with profound vasoplegic shock of unknown etiology which was refractory to vasopressors who responded within hours to a single dose of methylene blue. Additionally, we review the evidence of methylene blue's role in the treatment of shock...
2017: Case Reports in Critical Care
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