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https://www.readbyqxmd.com/read/29685512/causes-and-outcomes-of-finger-ischemia-in-hospitalized-patients-in-the-intensive-care-unit
#1
Gregory J Landry, Courtney J Mostul, Daniel S Ahn, Bryant J McLafferty, Timothy K Liem, Erica L Mitchell, Enjae Jung, Cherrie Z Abraham, Amir F Azarbal, Robert B McLafferty, Gregory L Moneta
OBJECTIVE: Vascular surgeons may be consulted to evaluate hospitalized patients with finger ischemia. We sought to characterize causes and outcomes of finger ischemia in intensive care unit (ICU) patients. METHODS: All ICU patients who underwent evaluation for finger ischemia from 2008 to 2015 were reviewed. All were evaluated with finger photoplethysmography. The patients' demographics, comorbidities, ICU care (ventilator status, arterial lines, use of vasoactive medications), finger amputations, and survival were also recorded...
April 20, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29669783/vasoactive-intestinal-peptide-ameliorates-acute-myocarditis-and-atherosclerosis-by-regulating-inflammatory-and-autoimmune-responses
#2
Raquel Benitez, Virginia Delgado-Maroto, Marta Caro, Irene Forte-Lago, Mario Duran-Prado, Francisco O'Valle, Andrew H Lichtman, Elena Gonzalez-Rey, Mario Delgado
Vasoactive intestinal peptide (VIP) is a neuropeptide that exerts various vascular and cardioprotective functions and regulates immune function and inflammatory response at multiple levels. However, its role in inflammatory cardiovascular disorders is largely unknown. Myocarditis and atherosclerosis are two inflammatory and autoimmune cardiovascular diseases that cause important adverse circulatory events. In this study, we investigate the therapeutic effects of VIP in various well-established preclinical models of experimental autoimmune myocarditis and atherosclerosis...
April 18, 2018: Journal of Immunology: Official Journal of the American Association of Immunologists
https://www.readbyqxmd.com/read/29664811/assessment-of-endothelium-independent-vasodilation-from-methodology-to-clinical-perspectives
#3
Tatsuya Maruhashi, Yasuki Kihara, Yukihito Higashi
: Vascular response to exogenously administered nitroglycerine, an index of endothelium-independent vasodilation, has been used as a control test for the assessment of endothelium-dependent vasodilation (endothelial function) in humans. However, evidence has been accumulating that not only endothelium-dependent vasodilation but also endothelium-independent vasodilation per se is impaired in individuals with cardiovascular risk factors and cardiovascular disease. Impaired endothelium-independent vasodilation is associated with structural vascular alterations and alterations in vascular smooth muscle cells...
April 16, 2018: Journal of Hypertension
https://www.readbyqxmd.com/read/29660924/vasopressor-support-vs-liberal-fluid-administration-in-deep-inferior-epigastric-perforator-diep-free-flap-breast-reconstruction-a-randomized-controlled-trial
#4
A M Anker, L Prantl, C Strauss, V Brébant, N Heine, P Lamby, S Geis, F Schenkhoff, M Pawlik, S M Klein
BACKGROUND: Perioperatively, patients' hemodynamics are modulated predominantly by intravenous fluid administration and vasoactive pharmacological support. Vasopressor agents are suspected to be detrimental on free flap survival by the cause of vasoconstriction of the pedicle with consecutive reduced overall flap perfusion and by aggravation of flap dissection. OBJECTIVE: A novel, standardized fluid restrictive perioperative hemodynamic management was assessed for its feasibility in clinical practice in free flap patients undergoing breast reconstruction...
April 7, 2018: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/29627071/ultrasound-versus-anatomical-landmarks-immediate-complications-in-the-central-venous-catheterization-in-children-under-18-years-of-age
#5
D Rivera-Tocancipá, E Díaz-Sánchez, C A Montalvo-Arce
INTRODUCTION: The insertion of a central venous line in children and adolescents is technically more difficult, due to the smaller size of the structures. This can lead to an increase in immediate complications, which can be reduced when using ultrasound. In our institution, the percentage of these complications and the use of ultrasound are unknown. OBJECTIVE: To describe the frequency of immediate complications of central venous catheterisation guided by the ultrasound in a general university hospital, compared to the anatomical landmarks technique in children less than 18years of age...
April 4, 2018: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/29624533/profound-intraoperative-hypotension-associated-with-transfusion-via-the-belmont-fluid-management-system
#6
Joanna Miller, Sang Kim, Dieter Adelmann, Bryan Hill, Nicolette Schlichting, Natalie Smith, Samuel DeMaria, Jeron Zerillo
This retrospective observational case series conducted at 2 large academic centers over a 4-year period consists of 15 cases of profound hypotension in surgical patients immediately after initiation of the Belmont Fluid Management System for rapid transfusion of blood products. Halting the infusion and administering vasoactive agents led to resolution of hypotension. Repeat transfusion with the Belmont system resulted in repeat hypotension unless counteracted with vasopressors. No etiology was elucidated. This represents the largest documented association of acute hypotensive transfusion reaction with any rapid infusion system in surgical patients...
April 5, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29621027/cardiac-output-monitoring-how-to-choose-the-optimal-method-for-the-individual-patient
#7
Bernd Saugel, Jean-Louis Vincent
PURPOSE OF REVIEW: To review the different methods available for the assessment of cardiac output (CO) and describe their specific indications in intensive care and perioperative medicine. RECENT FINDINGS: In critically ill patients, persistent circulatory shock after initial resuscitation is an indication for the assessment of CO to monitor the response to fluids and vasoactive agents. In patients with circulatory shock associated with right ventricular dysfunction, pulmonary artery hypertension, or acute respiratory distress syndrome, invasive CO monitoring using indicator dilution methods is indicated...
April 4, 2018: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29607780/brain-death-in-intensive-care-units-problems-differences-in-methods-of-diagnosis-and-donor-care
#8
Aykut Sarıtaş, Burcu Acar Çinleti, Çiler Zincircioğlu, Uğur Uzun, Işıl Köse, Nimet Şenoğlu
OBJECTIVES: Our aim was to investigate the most common problems in diagnosing brain death, the care of the organ donor, and organ donation after death. MATERIALS AND METHODS: A survey was sent randomly to clinicians working in national intensive care units in Turkey. The survey, which consisted of 17 questions for clinicians, had 163 responders. RESULTS: The most common cause of brain death was traumatic brain injury. Although 22% of clinicians found the apnea test necessary for brain death diagnosis, 78% stated that it could be used as an optional confirmatory test...
April 2, 2018: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/29587461/the-impact-of-t-2-toxin-on-vasoactive-intestinal-polypeptide-like-immunoreactive-vip-li-nerve-structures-in-the-wall-of-the-porcine-stomach-and-duodenum
#9
Krystyna Makowska, Kazimierz Obremski, Slawomir Gonkowski
T-2 toxin is a secondary metabolite of some Fusarium species. It is well-known that this substance can harmfully impact living organisms. Among others, thanks to the ability of crossing the blood-brain barrier, T-2 toxin can affect the central nervous system. Mycotoxins mostly get into the organism through the digestive tract; therefore, first of all they have to break the intestinal barrier, wherein the important component is the enteric nervous system (ENS). However, knowledge about the impact of T-2 toxin on the ENS is rather scant...
March 26, 2018: Toxins
https://www.readbyqxmd.com/read/29582666/a-blast-from-the-past-revival-of-angiotensin-ii-for-vasodilatory-shock
#10
Brittany D Bissell, Kelsey Browder, Matt McKenzie, Alexander H Flannery
OBJECTIVE: To review and summarize data on angiotensin II (AT-II), approved by the Food and Drug Administration (FDA) in December 2017 to increase blood pressure in adults with septic or other distributive shock. DATA SOURCES: A PubMed/MEDLINE search was conducted using the following terms: (angiotensin ii OR angiotensin 2) AND (shock) from 1966 to February 2018. STUDY SELECTION AND DATA EXTRACTION: A total of 691 citations were reviewed with only relevant clinical data extracted...
March 1, 2018: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/29569130/correlation-of-noninvasive-blood-pressure-and-invasive-intra-arterial-blood-pressure-in-patients-treated-with-vasoactive-medications-in-a-neurocritical-care-unit
#11
Ali A Saherwala, Sonja E Stutzman, Mohamed Osman, Junaid Kalia, Stephen A Figueroa, DaiWai M Olson, Venkatesh Aiyagari
BACKGROUND: The correlation between noninvasive (oscillometric) blood pressure (NBP) and intra-arterial blood pressure (IAP) in critically ill patients receiving vasoactive medications in a Neurocritical Care Unit has not been systematically studied. The purpose of this study is to examine the relationship between simultaneously measured NBP and IAP recordings in these patients. METHODS: Prospective observational study of patients (N = 70) admitted to a neurocritical care unit receiving continuous vasopressor or antihypertensive infusions...
March 22, 2018: Neurocritical Care
https://www.readbyqxmd.com/read/29566700/review-of-14-drowning-publications-based-on-the-utstein-style-for-drowning
#12
REVIEW
Allart M Venema, Anthony R Absalom, Ahamed H Idris, Joost J L M Bierens
BACKGROUND: The Utstein style for drowning (USFD) was published in 2003 with the aim of improving drowning research. To support a revision of the USFD, the current study aimed to generate an inventory of the use of the USFD parameters and compare the findings of the publications that have used the USFD. METHODS: A search in Pubmed, Embase, the Cochrane Library, Web of Science and Scopus was performed to identify studies that used the USFD and were published between 01-10-2003 and 22-03-2015...
March 22, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29562813/role-of-wnt-signaling-during-inflammation-and-sepsis-a-review-of-the-literature
#13
Khosrow Siamak Houschyar, Malcolm P Chelliah, Susanne Rein, Zeshaan N Maan, Kristian Weissenberg, Dominik Duscher, Ludwik K Branski, Frank Siemers
Despite the development of modern intensive care and new antimicrobial agents, the mortality of patients with severe sepsis and septic shock remains high. Systemic inflammation is a consequence of activation of the innate immune system. It is characterized by the intravascular release of proinflammatory cytokines and other vasoactive mediators, with concurrent activation of innate immune cells. The Wnt signaling pathway plays a critical role in the development of multicellular organisms. Abnormal Wnt signaling has been associated with many human diseases, ranging from inflammation and degenerative diseases to cancer...
March 1, 2018: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/29524352/the-role-and-mechanism-of-action-of-menthol-in-topical-analgesic-products
#14
REVIEW
J V Pergolizzi, R Taylor, J-A LeQuang, R B Raffa
WHAT IS KNOWN AND OBJECTIVE: Menthol has been used as a non-opioid pain reliever since ancient times. A modern understanding of its molecular mechanism of action could form the basis for generating targets for discovery of novel non-opioid analgesic drugs. METHODS: The PubMed database was queried using search words related to menthol, pain and analgesia. The results were limited to relevant preclinical studies and clinical trials and reviews published in English during the past 5 years, which yielded 31 reports...
March 10, 2018: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/29523882/hiv-based-lentivirus-mediated-vasoactive-intestinal-peptide-gene-delivery-protects-against-dio-animal-model-of-type-2-diabetes
#15
Hale M Tasyurek, Yunus E Eksi, Ahter D Sanlioglu, Hasan A Altunbas, Mustafa K Balci, Thomas S Griffith, Salih Sanlioglu
Type 2 diabetes mellitus (T2DM) is characterised by insulin resistance, glucose intolerance and beta cell loss leading to hyperglycemia. Vasoactive intestinal peptide (VIP) has been regarded as a novel therapeutic agent for the treatment of T2DM because of its insulinotropic and anti-inflammatory properties. Despite these beneficial properties, VIP is extremely sensitive to peptidases (DPP-4) requiring constant infusion or multiple injections to observe any therapeutic benefit. Thus, we constructed an HIV-based lentiviral vector encoding human VIP (LentiVIP) to test the therapeutic efficacy of VIP peptide in a diet-induced obesity (DIO) animal model of T2DM...
March 9, 2018: Gene Therapy
https://www.readbyqxmd.com/read/29520345/effects-of-splanchnic-vasoconstrictors-on-liver-regeneration-and-survival-after-90-rat-hepatectomy
#16
Dong-Sik Kim, Woong Bae Ji, Jae Hyun Han, Yoon Young Choi, Hyun-Jin Park, Young-Dong Yu, Ju Young Kim
Purpose: Posthepatectomy liver failure is a serious complication and considered to be caused by increased portal pressure and flow. Splanchnic vasoactive agents and propranolol are known to decrease portal pressure. The aim of this study was to identify optimal candidates with potential for clinical use among somatostatin, terlipressin, and propranolol using rats with 90% hepatectomy. Methods: Rats were divided into 5 groups: sham operation (n = 6), control (n = 20), propranolol (n = 20), somatostatin (n = 20), and terlipressin group (n = 20)...
March 2018: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/29473355/-clinical-research-of-vasospasm-and-vagus-reflex-during-radial-artery-puncture-treated-with-auricular-point-sticking
#17
Xiaoyan Fan, Yanping Liu, Jinhong Xie, Yushan Chen, Yanyan Cao
OBJECTIVE: To evaluate the effect and clinical value of auricular point sticking for the diagnosis and treatment of vasospasm and vagus reflex during radial artery puncture, including radial artery spasm (RAS) and coronary artery spasm (CAS). METHODS: A total of 480 patients were randomized into an observation group (224 cases) and a control group (256 cases). Percutaneous coronary intervention and usual care in perioperative period were used in the control group...
February 12, 2018: Zhongguo Zhen Jiu, Chinese Acupuncture & Moxibustion
https://www.readbyqxmd.com/read/29467961/the-outcomes-and-prognostic-factors-of-acute-respiratory-failure-in-the-patients-90-years-old-and-over
#18
Wan-Ling Chen, Chin-Ming Chen, Shu-Chen Kung, Ching-Min Wang, Chih-Cheng Lai, Chien-Ming Chao
This retrospective cohort study investigated the outcomes and prognostic factors in nonagenarians (patients 90 years old or older) with acute respiratory failure. Between 2006 and 2016, all nonagenarians with acute respiratory failure requiring invasive mechanical ventilation (MV) were enrolled. Outcomes including in-hospital mortality and ventilator dependency were measured. A total of 173 nonagenarians with acute respiratory failure were admitted to the intensive care unit (ICU). A total of 56 patients died during the hospital stay and the rate of in-hospital mortality was 32...
January 23, 2018: Oncotarget
https://www.readbyqxmd.com/read/29441350/perioperative-goal-directed-therapy-using-invasive-uncalibrated-pulse-contour-analysis
#19
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
#20
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
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