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https://www.readbyqxmd.com/read/29456606/sudden-cardiac-arrest-in-hypertrophic-cardiomyopathy-with-dynamic-cavity-obstruction-the-case-for-a-decatecholaminisation-strategy
#1
Cosmin Balan, Adrian View-Kim Wong
Catecholamines are entrenched in the management of shock states. A paradigm shift has pervaded the critical care arena in recent years acknowledging their propensity to cause harm and fuel a 'death-spiral'. We present the case of a 21-year-old male following a witnessed out-of-hospital cardiac arrest who received high-quality cardiopulmonary resuscitation and standard advanced life support for refractory ventricular fibrillation until return of spontaneous circulation after 70 min. Early post-admission echocardiography revealed severe diffuse sub-basal left ventricular hypertrophy with dynamic mid-cavity obstruction and akinetic apical pouching...
February 2018: Journal of the Intensive Care Society
https://www.readbyqxmd.com/read/29456603/successful-management-of-70-acetic-acid-ingestion-on-the-intensive-care-unit-a-case-report
#2
Andrew Ratcliffe, Andrew Baker, Daniel Smith
Acetic acid is an organic acid available in concentrations from 2 to 80%. Whilst lower concentrations of 2-6% are more commonly used as the table top condiment, vinegar, much stronger solutions are regularly used in Eastern Europe as food preservatives and cleaning solutions. Oral ingestion of greater than 12% has been reported to cause haemolysis, renal failure, shock and death. Most reported cases of deliberate or accidental poisoning are from Russia and Eastern Europe in the 1980s, with very little currently in western publications...
February 2018: Journal of the Intensive Care Society
https://www.readbyqxmd.com/read/29455711/evaluation-of-the-benefits-of-de-escalation-for-patients-with-sepsis-in-the-emergency-intensive-care-unit
#3
Takahiro Niimura, Yoshito Zamami, Toru Imai, Kanako Nagao, Masafumi Kayano, Hidenori Sagara, Mitsuhiro Goda, Naoto Okada, Masayuki Chuma, Kenshi Takechi, Masaki Imanishi, Toshihiro Koyama, Tadashi Koga, Hironori Nakura, Toshiaki Sendo, Keisuke Ishizawa
PURPOSE: Although the 2016 Japanese guidelines for the management of sepsis recommend de-escalation of treatment after identification of the causative pathogen, adherence to this practice remain unknown. The objective of this study was to evaluate the benefits of de-escalating treatment for sepsis patients at an advanced critical care and emergency medical centre. METHODS: Based on electronic patient information, 85 patients who were transported to the centre by ambulance, and diagnosed with sepsis between January 2008 and September 2013 were enrolled and evaluated...
2018: Journal of Pharmacy & Pharmaceutical Sciences: a Publication of the Canadian Society for Pharmaceutical Sciences
https://www.readbyqxmd.com/read/29446472/hantavirus-induced-cardiopulmonary-syndrome-a-public-health-concern
#4
REVIEW
Sibghat Tul Llah, Sheema Mir, Sumaiya Sharif, Salman Khan, Mohammed A Mir
Hantavirus cardiopulmonary syndrome is characterized by pulmonary capillary leakage and alveolar flooding, resulting in 50% mortality due to fulminant hypoxic respiratory failure. In addition, depression of cardiac function ensues, which complicates the picture with cardiogenic shock. Early diagnosis and appropriate use of extracorporeal membrane oxygenation (ECMO) are amongst the lifesaving interventions in this fatal illness. However, a recent case report demonstrates that implementation of high volume continuous hemofilteration along with protective ventilation reverses the cardiogenic shock within few hours in hantavirus infected patients...
February 15, 2018: Journal of Medical Virology
https://www.readbyqxmd.com/read/29445505/the-japanese-clinical-practice-guidelines-for-management-of-sepsis-and-septic-shock-2016-j-sscg-2016
#5
Osamu Nishida, Hiroshi Ogura, Moritoki Egi, Seitaro Fujishima, Yoshiro Hayashi, Toshiaki Iba, Hitoshi Imaizumi, Shigeaki Inoue, Yasuyuki Kakihana, Joji Kotani, Shigeki Kushimoto, Yoshiki Masuda, Naoyuki Matsuda, Asako Matsushima, Taka-Aki Nakada, Satoshi Nakagawa, Shin Nunomiya, Tomohito Sadahiro, Nobuaki Shime, Tomoaki Yatabe, Yoshitaka Hara, Kei Hayashida, Yutaka Kondo, Yuka Sumi, Hideto Yasuda, Kazuyoshi Aoyama, Takeo Azuhata, Kent Doi, Matsuyuki Doi, Naoyuki Fujimura, Ryota Fuke, Tatsuma Fukuda, Koji Goto, Ryuichi Hasegawa, Satoru Hashimoto, Junji Hatakeyama, Mineji Hayakawa, Toru Hifumi, Naoki Higashibeppu, Katsuki Hirai, Tomoya Hirose, Kentaro Ide, Yasuo Kaizuka, Tomomichi Kan'o, Tatsuya Kawasaki, Hiromitsu Kuroda, Akihisa Matsuda, Shotaro Matsumoto, Masaharu Nagae, Mutsuo Onodera, Tetsu Ohnuma, Kiyohiro Oshima, Nobuyuki Saito, So Sakamoto, Masaaki Sakuraya, Mikio Sasano, Norio Sato, Atsushi Sawamura, Kentaro Shimizu, Kunihiro Shirai, Tetsuhiro Takei, Muneyuki Takeuchi, Kohei Takimoto, Takumi Taniguchi, Hiroomi Tatsumi, Ryosuke Tsuruta, Naoya Yama, Kazuma Yamakawa, Chizuru Yamashita, Kazuto Yamashita, Takeshi Yoshida, Hiroshi Tanaka, Shigeto Oda
Background and Purpose: The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J-SSCG 2016), a Japanese-specific set of clinical practice guidelines for sepsis and septic shock created jointly by the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine, was first released in February 2017 in Japanese. An English-language version of these guidelines was created based on the contents of the original Japanese-language version...
January 2018: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29443862/red-tides-mass-casualty-and-whole-blood-at-sea-red-tides
#6
Benjamin T Miller, Andrew H Lin, Susan C Clark, Andrew P Cap, Joseph J Dubose
BACKGROUND: The U.S. Navy's casualty-receiving ships provide remote damage control resuscitation (RDCR) platforms to treat injured combatants deployed afloat and ashore. We report a significant mass casualty incident aboard the USS Bataan, and the most warm fresh whole blood (WFWB) transfused at sea for traumatic hemorrhagic shock since the Vietnam War. METHODS: Casualty-receiving ships have robust medical capabilities, including a frozen blood bank with packed red blood cells (pRBC) and fresh frozen plasma (FFP)...
February 13, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29443857/the-fast-exam-can-reliably-identify-patients-with-significant-intraabdominal-hemorrhage-in-life-threatening-pelvic-fractures
#7
Nicole Townsend Christian, Clay Cothren Burlew, Ernest E Moore, Andrea E Geddes, Amy E Wagenaar, Charles J Fox, Fredric M Pieracci
BACKGROUND: The Focused Abdominal Sonography for Trauma (FAST) exam has been reported to be unreliable in pelvic fracture patients. Additionally, given the advent of new therapeutic interventions, such as Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA), rapid identification of intraabdominal hemorrhage compared to zone III hemorrhage may guide different therapeutic strategies. We hypothesized that FAST is reliable for detecting clinically significant intraabdominal hemorrhage in the face of complex pelvic fractures...
February 14, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29440469/air-drop-blood-supply-in-the-french-army
#8
Olivier Javaudin, A Baillon, N Varin, C Martinaud, T Pouget, C Civadier, B Clavier, A Sailliol
BACKGROUND: Haemorrhagic shock remains the leading cause of preventable death in overseas and austere settings. Transfusion of blood components is critical in the management of this kind of injury. For French naval and ground military units, this supply often takes too long considering the short shelf-life of red blood cell concentrates (RBCs) and the limited duration of transport in cooling containers (five to six days). Air-drop supply could be an alternative to overcome these difficulties on the condition that air-drop does not cause damage to blood units...
February 12, 2018: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/29440235/do-patients-with-blunt-thoracic-aortic-injury-present-to-hospital-with-unstable-vital-signs-a-systematic-review-and-meta-analysis
#9
Jordan Bade-Boon, Joseph K Mathew, Mark C Fitzgerald, Biswadev Mitra
BACKGROUND: Blunt thoracic aortic injury (BTAI) is an uncommon diagnosis, usually developing as a consequence of high-impact acceleration-deceleration mechanisms. Timely diagnosis may enable early resuscitation and reduction of shear forces, essential to prevent worsening of the injury prior to definitive management. Death is commonly due to haemorrhagic shock, but clinical features may be absent until sudden and massive haemorrhage. OBJECTIVES: The aim of this systematic review was to determine the proportion of patients with BTAI who present with unstable vital signs...
February 9, 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29437714/symmetrical-peripheral-gangrene-of-bilateral-feet-and-unilateral-hand-after-administration-of-vasopressors-during-septic-shock
#10
Naeemah Ruffin, Chirag V Vasa, Sarah Breakstone, Wayne Axman
We report a case of a 75-year-old Hispanic man treated for septic shock after undergoing surgery for impacted renal stones. He was given vasopressors and later developed symmetrical peripheral gangrene (SPG) on both his feet and left hand. SPG is a serious and rare condition presenting clinically as an acute onset of ischaemia with no vessel occlusion. Vasopressors are identified as a contributing factor in SPG development. The patient ultimately underwent transmetatarsal amputations of both feet and amputation of three digits on his left hand...
February 7, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29435656/-management-of-inappropriate-shocks-t-wave-oversensing-in-s-icd%C3%A2-patients
#11
REVIEW
Robert Larbig, Markus Bettin, Lukas J Motloch, Alicia Fischer, Niklas Bode, Gerrit Frommeyer, Florian Reinke, Andreas Loeher, Lars Eckardt, Julia Köbe
Inappropriate shocks are a feared complication after implantable cardioverter-defibrillator (ICD) implantation and have a tremendous impact on quality of life. Inappropriate shocks in patients with subcutaneous ICD (S-ICD®, Boston Scientific, Marlborough, MA, USA) have various underlying causes. This review summarizes the current literature on this topic and lists possible treatment options.
February 12, 2018: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29435330/the-japanese-clinical-practice-guidelines-for-management-of-sepsis-and-septic-shock-2016-j-sscg-2016
#12
Osamu Nishida, Hiroshi Ogura, Moritoki Egi, Seitaro Fujishima, Yoshiro Hayashi, Toshiaki Iba, Hitoshi Imaizumi, Shigeaki Inoue, Yasuyuki Kakihana, Joji Kotani, Shigeki Kushimoto, Yoshiki Masuda, Naoyuki Matsuda, Asako Matsushima, Taka-Aki Nakada, Satoshi Nakagawa, Shin Nunomiya, Tomohito Sadahiro, Nobuaki Shime, Tomoaki Yatabe, Yoshitaka Hara, Kei Hayashida, Yutaka Kondo, Yuka Sumi, Hideto Yasuda, Kazuyoshi Aoyama, Takeo Azuhata, Kent Doi, Matsuyuki Doi, Naoyuki Fujimura, Ryota Fuke, Tatsuma Fukuda, Koji Goto, Ryuichi Hasegawa, Satoru Hashimoto, Junji Hatakeyama, Mineji Hayakawa, Toru Hifumi, Naoki Higashibeppu, Katsuki Hirai, Tomoya Hirose, Kentaro Ide, Yasuo Kaizuka, Tomomichi Kan'o, Tatsuya Kawasaki, Hiromitsu Kuroda, Akihisa Matsuda, Shotaro Matsumoto, Masaharu Nagae, Mutsuo Onodera, Tetsu Ohnuma, Kiyohiro Oshima, Nobuyuki Saito, So Sakamoto, Masaaki Sakuraya, Mikio Sasano, Norio Sato, Atsushi Sawamura, Kentaro Shimizu, Kunihiro Shirai, Tetsuhiro Takei, Muneyuki Takeuchi, Kohei Takimoto, Takumi Taniguchi, Hiroomi Tatsumi, Ryosuke Tsuruta, Naoya Yama, Kazuma Yamakawa, Chizuru Yamashita, Kazuto Yamashita, Takeshi Yoshida, Hiroshi Tanaka, Shigeto Oda
Background and purpose: The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J-SSCG 2016), a Japanese-specific set of clinical practice guidelines for sepsis and septic shock created jointly by the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine, was first released in February 2017 and published in the Journal of JSICM , [2017; Volume 24 (supplement 2)] 10.3918/jsicm.24S0001 and Journal of Japanese Association for Acute Medicine [2017; Volume 28, (supplement 1)] http://onlinelibrary...
2018: Journal of Intensive Care
https://www.readbyqxmd.com/read/29435167/pentraxin-3-procalcitonin-and-lactate-as-prognostic-markers-in-patients-with-sepsis-and-septic-shock
#13
Chenggong Hu, Yongfang Zhou, Chang Liu, Yan Kang
The purpose of this study was to confirm the prognostic value of pentraxin-3 (PTX3), procalcitonin (PCT) and lactate in patients with severe infections requiring ICU management and to develop and validate a model to enhance mortality prediction by combining severity scores with biomarkers. We included 141 patients with the diagnosis of sepsis/septic shock. The levels of PTX3, PCT and lactate were measured on day 0, 3, 7 of hospitalization and Sequential Organ Failure Assessment (SOFA) and Acute Physiology and Chronic Health Evaluation II (APACHE II) scores were also evaluated...
January 12, 2018: Oncotarget
https://www.readbyqxmd.com/read/29434689/lower-energy-radial-shock-wave-therapy-improves-characteristics-of-hypertrophic-scar-in-a-rabbit-ear-model
#14
Jing-Chun Zhao, Bo-Ru Zhang, Kai Shi, Jian Wang, Qing-Hua Yu, Jia-Ao Yu
The aim of the present study was to investigate the effects of radial extracorporeal shock wave therapy (rESWT) on scar characteristics and transforming growth factor (TGF)-β1/Smad signaling in order to explore a potential modality for the treatment of hypertrophic scars (HS). The HS model was generated in rabbit ears, then rabbits were randomly divided into 3 groups: Lower (L)-ESWT [treated with rESWT with lower energy flux density (EFD) of 0.1 mJ/mm2], higher (H)-ESWT (treated with a higher EFD of 0.18 mJ/mm2) and the sham ESWT group (S-ESWT; no ESWT treatment)...
January 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29433603/is-distance-to-the-nearest-registered-public-automated-defibrillator-associated-with-the-probability-of-bystander-shock-for-victims-of-out-of-hospital-cardiac-arrest
#15
Joel Neves Briard, Luc de Montigny, Dave Ross, François de Champlain, Eli Segal
Introduction Rapid access to defibrillation is a key element in the management of out-of-hospital cardiac arrests (OHCAs). Public automated external defibrillators (PAEDs) are becoming increasingly available, but little information exists regarding the relation between the proximity to the arrest and their usage in urban areas. METHODS: This study is a retrospective, observational, cross-sectional analysis of non-traumatic OHCA during a 24-month period in the greater Montreal area (Quebec, Canada)...
February 13, 2018: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/29428539/vascular-trauma-in-children-review-from-a-major-paediatric-centre
#16
REVIEW
Sofia Morão, Rita S Ferreira, Nelson Camacho, Vanda Pratas Vital, J Pascoal, M Emília Ferreira, L Mota Capitão, Frederico B Gonçalves
INTRODUCTION: Traumatic non-iatrogenic vascular injuries in children are rare and rarely discussed in literature. Paediatric vascular injuries pose a set of challenges mainly because of continued growth and development in a child or adolescent. The purpose of the study is to characterize management strategies and outcomes in these cases. PATIENTS AND METHODS: Single-centre retrospective review of patients less than age 18 years (paediatric age) with acute, non-iatrogenic traumatic vascular injuries between January 2009 and December 2015...
February 8, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29426363/effect-of-heat-shock-on-hot-water-plumbing-microbiota-and-legionella-pneumophila-control
#17
Pan Ji, William J Rhoads, Marc A Edwards, Amy Pruden
BACKGROUND: Heat shock is a potential control strategy for Legionella pneumophila in hot water plumbing systems. However, it is not consistently effective, with little understanding of its influence on the broader plumbing microbiome. Here, we employed a lab-scale recirculating hot water plumbing rig to compare the pre- and post-"heat shock" (i.e., 40 → 60 → 40 °C) microbiota at distal taps. In addition, we used a second plumbing rig to represent a well-managed system at 60 °C and conducted a "control" sampling at 60 °C, subsequently reducing the temperature to 40 °C to observe the effects on Legionella and the microbiota under a simulated "thermal disruption" scenario...
February 9, 2018: Microbiome
https://www.readbyqxmd.com/read/29426281/primary-percutaneous-coronary-intervention-during-st-elevation-myocardial-infarction-in-prosthetic-valve-endocarditis-a-case-report
#18
Alfonso Campanile, Guido Tavazzi, Francesco Caprioglio, Fausto Rigo
BACKGROUND: Infective endocarditis (IE) is still a condition with high mortality and morbidity, especially in the elderly, and in patients with prosthetic valves. The concept of "time-to-therapy" plays a key role for the prompt management of IE and related complications, and the currently available multimodality imaging may play a key role in this setting. Myocardial ischemia due to extrinsic coronary compression from an aortic abscess is an extremely rare condition where the optimal therapeutic strategy has not been defined yet...
February 9, 2018: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/29426052/-ssc-international-guideline-2016-management-of-sepsis-and-septic-shock
#19
Tim Rahmel
The new guideline of the Surviving Sepsis Campaign was revised in 2016 and presented in 2017. Furthermore, "Sepsis-3" in 2016 completely changed the definition of Sepsis from inflammation plus infection to a "life-threatening organ dysfunction caused by a dysregulated host response". To cope with the great challenge to unite the new evidence of sepsis treatment with the new definition of sepsis, the guidelines have been completely reconstructed and comprehensively deal with new evidence...
February 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29422823/anaphylaxis-in-poland-the-epidemiology-and-direct-costs
#20
Karina Jahnz-Rozyk, Filip Raciborski, Andrzej M Śliwczyński, Anna Kłak, Jarosław Pinkas
Introduction: Epidemiological data on anaphylaxis have been underestimated both in Poland and worldwide. Aim: To evaluate the prevalence of anaphylaxis in Poland, including a classification by gender, age and residential region. Material and methods: The data used in the analysis were derived from two sources, the National Health Fund records of healthcare services for 2008-2015 (official statistics) and a questionnaire-based survey conducted in 2015 on a sample of 305 allergists practicing in different regions of Poland...
December 2017: Postȩpy Dermatologii i Alergologii
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