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https://www.readbyqxmd.com/read/29230546/management-and-predictors-of-outcome-in-unselected-patients-with-cardiogenic-shock-complicating-acute-st-segment-elevation-myocardial-infarction-results-from-the-bremen-stemi-registry
#1
Tina Backhaus, Andreas Fach, Johannes Schmucker, Eduard Fiehn, Daniela Garstka, Janina Stehmeier, Rainer Hambrecht, Harm Wienbergen
INTRODUCTION: Patients with ST-segment elevation myocardial infarction (STEMI) and consecutive cardiogenic shock (CS) represent a challenge in clinical practice. Only few 'real-world' data on therapeutic management and outcome exist. METHODS: The present analysis focuses on changes of clinical management of STEMI-patients with CS and analyzes predictors of outcome using the Bremen-STEMI registry. RESULTS: Out of 7865 patients with STEMI, 981 patients (13%) presented with CS...
December 11, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/29230528/cofactor-f430-as-a-biomarker-for-methanogenic-activity-application-to-an-anaerobic-bioreactor-system
#2
I Passaris, P Van Gaelen, R Cornelissen, K Simoens, D Grauwels, L Vanhaecke, D Springael, I Smets
Over the last decades, anaerobic bioreactor technology proved to be a competitive technology for purifying wastewater while producing biogas. Methanogens perform the crucial final step in methane production, and monitoring their activity is of paramount importance for system understanding and management. Cofactor F430 is an essential prosthetic group of the methyl-coenzyme M reductase (MCR) enzyme catalysing this final step. This research investigates whether the quantification of cofactor F430 in bioreactor systems is a viable intermediate-complexity monitoring tool in comparison to the conventional biogas and volatile fatty acid (VFA) concentration follow-up and molecular genetic techniques targeting the mcrA gene encoding the MCR protein or its transcripts...
December 11, 2017: Applied Microbiology and Biotechnology
https://www.readbyqxmd.com/read/29229195/a-comparison-of-two-different-fluid-resuscitation-management-protocols-for-pediatric-burn-patients-a-retrospective-study
#3
Miao Huang, Jun-Feng Chen, Li-Ying Chen, Li-Qin Pan, Xiao-Jian Li, Jie-Yu Ye, Hui-Yi Tan
OBJECTIVE: Pediatric burn patients are more susceptible to burn shock than adults, and an effective fluid management protocol is critical to successful resuscitation. Our research aim was to investigate the safety and efficacy of two protocols for pediatric burn patients for use within the first 24h. METHODS: A total of 113 pediatric burn patients were enrolled from January 2007 to October 2012. Of those patients, 57 received fluid titration regimens of alternating crystalloids and colloids once within 2h in the first 24h after burn (Group A), whereas the remaining patients received regimens of alternating crystalloids and colloids once within 1h in the first 24h after burn (Group B)...
December 8, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/29227797/anticonvulsant-effects-of-acetaminophen-in-mice-comparison-with-the-effects-of-nonsteroidal-anti-inflammatory-drugs
#4
Katsuya Suemaru, Misato Yoshikawa, Akihiro Tanaka, Hiroaki Araki, Hiroaki Aso, Masahiko Watanabe
OBJECTIVE: The appropriate use of analgesic drugs based on their degree of analgesia and adverse effects is important for pain management. Although it has been reported that AM404, a metabolite of acetaminophen, has anticonvulsant effects in several animal seizure models, little is known about the relation between acetaminophen and seizures. We therefore investigated the effects of acetaminophen on seizure susceptibility in several mouse seizure and epilepsy models and compared the effects with those of nonsteroidal anti-inflammatory drugs (NSAIDs)...
December 5, 2017: Epilepsy Research
https://www.readbyqxmd.com/read/29227368/septic-cardiomyopathy
#5
Sarah J Beesley, Gerhard Weber, Todd Sarge, Sara Nikravan, Colin K Grissom, Michael J Lanspa, Sajid Shahul, Samuel M Brown
OBJECTIVES: To describe, with an emphasis on clinical applications, what is known about the pathophysiology, management, and implications of septic cardiomyopathy in the adult ICU. DATA SOURCES AND STUDY SELECTION: A PubMed literature review was performed for relevant articles. Only articles in English that studied human adults with sepsis were included. DATA EXTRACTION AND DATA SYNTHESIS: Multiple competing definitions for septic cardiomyopathy hinder understanding of this entity...
December 8, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29225011/effect-of-platelet-lymphocyte-ratio-and-lactate-levels-obtained-on-mortality-with-sepsis-and-septic-shock
#6
Ebru Biyikli, Afsin Emre Kayipmaz, Cemil Kavalci
BACKGROUND: Sepsis is a potentially fatal condition with high treatment costs, and is especially common among the elderly population. The emergency management of septic patients has gained importance. OBJECTIVE: Herein, we investigated the effect of admission lactate levels and the platelet-lymphocyte ratio (PLR) on the 30-day mortality among patients older than 65years who were diagnosed with sepsis and septic shock according to the qSOFA criteria at our hospital's emergency department...
December 6, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29224660/postpartum-hemorrhage
#7
Janice Newsome, Jonathan G Martin, Zachary Bercu, Jay Shah, Haris Shekhani, Gail Peters
Interventional radiologists are often called for emergent control of abnormal uterine bleeding. Bleeding, even heavy bleeding as a result of uterine fibroids is not a common emergent procedure; instead, pregnancy and pregnancy related conditions, trauma and malignancy associated with bleeding can be the source of many interventional radiology on call events or procedures. Postpartum hemorrhage (PPH) is the most common cause, and is defined as blood loss of 500mL after vaginal delivery or 1000mL after cesarean section...
December 2017: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29223724/vasoplegia-after-cardiovascular-procedures-pathophysiology-and-targeted-therapy
#8
REVIEW
Shahzad Shaefi, Aaron Mittel, John Klick, Adam Evans, Natalia S Ivascu, Jacob Gutsche, John G T Augoustides
Vasoplegic syndrome, characterized by low systemic vascular resistance and hypotension in the presence of normal or supranormal cardiac function, is a frequent complication of cardiovascular surgery. It is associated with a diffuse systemic inflammatory response and is mediated largely through cellular hyperpolarization, high levels of inducible nitric oxide, and a relative vasopressin deficiency. Cardiopulmonary bypass is a particularly strong precipitant of the vasoplegic syndrome, largely due to its association with nitric oxide production and severe vasopressin deficiency...
October 27, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29223709/bone-marrow-edema-syndrome-of-the-medial-femoral-condyle-treated-with-extracorporeal-shock-wave-therapy-a-clinical-and-mri-retrospective-comparative-study
#9
Matteo Vitali, Nadim Naim Rodriguez, Alberto Pedretti, Andreas Drossinos, Pierluigi Pironti, Gaia Di Carlo, Gianfranco Fraschini
OBJECTIVE: To determine the validity of Extracorporeal Shock Wave Therapy (ESWT) in the treatment of Bone Marrow Edema (BME) of the medial condyle of the knee DESIGN: Retrospective STUDY SETTING: IRCCS San Raffaele Hospital, Orthopedics Outpatient Clinic PARTICIPANTS: Fifty-six symptomatic patients affected by bone marrow edema of the medial condyle of the knee. Patients were equally divided in a ESWT (Extracorporeal Shock Wave Therapy) treated group and a control group, which was managed conservatively...
December 6, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/29221616/dengue-fever-report-from-the-task-force-on-tropical-diseases-by-the-world-federation-of-societies-of-intensive-and-critical-care-medicine
#10
REVIEW
Pravin Amin, Özlem Acicbe, Jorge Hidalgo, Juan Ignacio Silesky Jiménez, Tim Baker, Guy A Richards
Dengue is an arbovirus affecting humans and spread by mosquitoes. Severe dengue follows a secondary infection with a different virus serotype. The problem is truly global as it is endemic in over 100 countries. Severe dengue can be a life-threatening because of increased vascular permeability, resulting in leakage of fluid from the intravascular compartment to the extravascular space. When major bleeding does occur, it is almost invariably combined with profound shock since this, in combination with thrombocytopenia, hypoxia, and acidosis, can lead to multiple organ failure and disseminated intravascular coagulation...
November 5, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29221340/sudden-hypotension-occurring-after-4-days-of-left-sided-central-catheter-placement
#11
Youn-Jung Kim, Won Young Kim
Central venous catheters (CVCs) have an important role in the management of critically ill patients. In contrast to the immediate complications after CVC insertion, the late complications were difficult to be noticed without high suspicion despite their life-threatening outcome. We report a rare but fatal delayed vascular perforation occurring after 4 days of left-sided hemodialysis catheter insertion. A 74-year-old male with septic shock was treated with continuous renal replacement therapy (CRRT) and recovered smoothly during hospitalization...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29218314/endoscopic-pancreatic-balloon-sphincteroplasty-for-difficult-to-treat-pancreatic-stones-and-strictures-experience-in-80-patients
#12
Rinkesh Kumar Bansal, Gaurav Kumar Patil, Rajesh Puri, Narendra S Choudhary, Saurabh R Patle, Zubin D Sharma, Randhir Sud
Background and aim:  There is paucity of data about endoscopic pancreatic sphincteroplasty (EPS) after endoscopic pancreatic sphincterotomy (EPST) in the treatment of chronic pancreatitis. The aim of this study was to establish the indications for EPS, complications related to it, and to examine its effectiveness in managing chronic pancreatitis after a year of follow-up. Methods:  We evaluated the safety and efficacy of pancreatic balloon dilation coupled with sphincterotomy for the treatment of chronic pancreatitis...
December 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/29217889/spontaneous-splenic-haematoma-in-a-patient-on-hemodialysis-a-case-report
#13
J Pandiaraja
Spontaneous splenic hematoma is one of the rare and life-threatening complications of chronic renal failure. The diagnosis of splenic hematoma is mostly made by imaging such as ultrasound or computed tomography. The management of spontaneous splenic hematoma is not standardized till now due to the rarity of this condition. Splenectomy is recommended in hemodynamically unstable patients with features of shock. This is a case report of spontaneous splenic hematoma in a patient with chronic renal failure. This case is reported due to the rarity with renal failure...
November 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/29216924/dengue-hemorrhagic-fever-complicated-with-acute-liver-failure-a-case-report
#14
Chamara Dalugama, Indika Bandara Gawarammana
BACKGROUND: Dengue is a common arboviral infection with a clinically diverse spectrum of presentations. Although hepatic dysfunction is commonly identified in patients will dengue illness, acute liver failure is rare. The etiopathogenesis of hepatic dysfunction is multifactorial and related to direct viral invasion of hepatocytes, immunological factors and hypoxia particularly in cases of shock in dengue hemorrhagic fever. Ideal management of dengue-related hepatic dysfunction and acute liver failure is still debated...
December 8, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29214053/severe-carvedilol-toxicity-without-overdose-caution-in-cirrhosis
#15
Satish Maharaj, Karan Seegobin, Julio Perez-Downes, Belinda Bajric, Simone Chang, Pramod Reddy
Background: Carvedilol is used in the management of hypertension, ischemic heart disease, heart failure and most recently, portal hypertension. It has been associated with improved outcomes regarding variceal bleeding, hepatic decompensation and death when compared to propranolol and endoscopic band ligation. The main cause of portal hypertension is cirrhosis and therefore carvedilol is increasingly used in these patients. Due to its extensive hepatic metabolism, carvedilol is contraindicated in severe hepatic impairment...
2017: Clinical Hypertension
https://www.readbyqxmd.com/read/29212277/tumor-necrosis-factor-%C3%AE-308-g-a-polymorphism-and-risk-of-sepsis-septic-shock-and-mortality-an-updated-meta-analysis
#16
Hao Wang, Shujin Guo, Chun Wan, Ting Yang, Ni Zeng, Yanqiu Wu, Lei Chen, Yongchun Shen, Fuqiang Wen
Background: The -308G/A polymorphism in the gene encoding tumor necrosis factor-α (TNF-α) has been implicated in sepsis risk in many studies but with variable results. This study aimed to comprehensively assess the evidence of association between this polymorphism and risk of sepsis and sepsis-related mortality. Materials and Methods: PubMed, EMBASE and other databases were searched to identify relevant studies, and data were analyzed using Review Manager 5.0 and STATA 12...
November 7, 2017: Oncotarget
https://www.readbyqxmd.com/read/29211743/symptoms-associated-with-adverse-dengue-fever-prognoses-at-the-time-of-reporting-in-the-2015-dengue-outbreak-in-taiwan
#17
Chun-Yin Yeh, Po-Lin Chen, Kun-Ta Chuang, Yu-Chen Shu, Yu-Wen Chien, Guey Chuen Perng, Wen-Chien Ko, Nai-Ying Ko
BACKGROUND: Tainan experienced the most severe dengue epidemic in Taiwan in 2015. This study investigates the association between the signs and symptoms at the time of reporting with the adverse dengue prognoses. METHODS: A descriptive study was conducted using secondary data from the Dengue Disease Reporting System in Tainan, Taiwan, between January 1 and December 31, 2015. A multivariate stepwise logistic regression was used to identify the risk factors for the adverse prognoses: ICU admissions and mortality...
December 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/29210983/the-potential-pathogenic-contributions-of-endothelial-barrier-and-arterial-contractile-dysfunction-to-shock-due-to-b-anthracis-lethal-and-edema-toxins
#18
REVIEW
Dante A Suffredini, Xizhong Cui, Wanying Xu, Yan Li, Peter Q Eichacker
Shock with B. anthracis infection is particularly resistant to conventional cardiovascular support and its mortality rate appears higher than with more common bacterial pathogens. As opposed to many bacteria that lack exotoxins directly depressing hemodynamic function, lethal and edema toxin (LT and ET respectively) both cause shock and likely contribute to the high lethality rate with B. anthracis. Selective inhibition of the toxins is protective in infection models, and administration of either toxin alone in animals produces hypotension with accompanying organ injury and lethality...
December 6, 2017: Toxins
https://www.readbyqxmd.com/read/29209989/pancreaticoduodenal-artery-aneurysms-due-to-median-arcuate-ligament-syndrome-what-we-need-to-know
#19
A Peyrottes, D Mariage, P Baqué, D Massalou
Median arcuate ligament (MAL) syndrome is a rare and poorly known cause of abdominal pain. MAL narrows the celiac artery (CA), resulting in true distal aneurysms, including pancreaticoduodenal artery (PDA) aneurysms. These aneurysms often have an aggressive course, as rupture can result in hemorrhagic shock. CT scan appears to be the most effective investigation for the diagnosis of PDA aneurysms and may reveal possible celiac artery compression. In this series, we describe four cases of PDA aneurysm: two ruptured aneurysms treated by an endovascular procedure and two non-ruptured aneurysms treated by surgery...
December 5, 2017: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/29207766/successful-management-of-urosepsis-with-ceftriaxone-sulbactam-edta-a-case-report-of-penem-sparing-approach
#20
Amit Bery, Candy Sodhi, Rishu Bhanot
Over the past decade, the Anti-Microbial Resistance (AMR) among members of Enterobacteriaceae family is on rise mainly due to rapid spread of strains producing Extended-Spectrum Beta-Lactamases (ESBLs) and Metallo Beta-Lactamases (MBLs). Hence, the choice of drugs available for these resistant strains is diminishing and their treatment is becoming more challenging. This is a case of complicated Urinary Tract Infection (cUTI) due to ESBL producing E. coli leading to septic shock which was successfully managed with Antibiotic Adjuvant Entity (AAE), a combination of ceftriaxone+sulbactam+EDTA...
September 2017: Journal of Clinical and Diagnostic Research: JCDR
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