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https://www.readbyqxmd.com/read/28930959/outcomes-after-concomitant-traumatic-brain-injury-and-hemorrhagic-shock-a-secondary-analysis-from-the-pragmatic-randomized-optimal-platelets-and-plasma-ratios-trial
#1
Samuel M Galvagno, Erin E Fox, Savitri N Appana, Sarah Baraniuk, Patrick L Bosarge, Eileen M Bulger, Rachel A Callcut, Bryan A Cotton, Michael Goodman, Kenji Inaba, Terence O'Keeffe, Martin A Schreiber, Charles E Wade, Thomas M Scalea, John B Holcomb, Deborah M Stein
BACKGROUND: Often the clinician is faced with a diagnostic and therapeutic dilemma in patients with concomitant traumatic brain injury (TBI) and hemorrhagic shock (HS), as rapid deterioration from either can be fatal. Knowledge about outcomes after concomitant TBI and HS may help prioritize the emergent management of these patients. We hypothesized that patients with concomitant TBI and HS (TBI + HS) had worse outcomes and required more intensive care compared with patients with only one of these injuries...
October 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28930955/comparison-of-compensatory-reserve-and-arterial-lactate-as-markers-of-shock-and-resuscitation
#2
Michael Craig Johnson, Abdul Alarhayem, Victor Convertino, Robert Carter, Kevin Chung, Ronald Stewart, John Myers, Daniel Dent, Lilian Liao, Ramon Cestero, Susannah Nicholson, Mark Muir, Martin Schwaca, David Wampler, Mark DeRosa, Brian J Eastridge
BACKGROUND: During traumatic hemorrhage, the ability to identify shock and intervene before decompensation is paramount to survival. Lactate is extremely sensitive to shock, and its clearance has been demonstrated a useful gauge of shock and resuscitation status. Though lactate can be measured in the field, logistical constraints render it impractical in certain environments. The compensatory reserve represents a new clinical measurement reflecting the remaining capacity to compensate for hypoperfusion...
October 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28930837/the-prognostic-value-of-shock-index-for-the-outcomes-of-acute-myocardial-infarction-patients-a-systematic-review-and-meta-analysis
#3
Xiaocong Zhang, Zejie Wang, Zhenyu Wang, Manling Fang, Zhouwu Shu
BACKGROUND: Several studies have revealed that high shock index (SI) is a risk factor for acute myocardial infarction (AMI) patients. These studies do not give a systematic review in this issue. Therefore, we conducted a systematic review and meta-analysis to determine the effect of high SI on the prognosis of AMI patients. METHODS: We did a systematic search of PubMed, Embase, and the Cochrane Library, using various combinations of keywords such as "shock index," "shock-index," "acute myocardial infarction," "ST elevation myocardial infarction," "non-ST segment elevation myocardial infarction," "STEMI," "NSTEMI," "AMI," and "MI" for eligible studies published up to December 23, 2016...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28922146/preliminary-clinical-evaluation-of-automated-analysis-of-the-sublingual-microcirculation-in-the-assessment-of-patients-with-septic-shock-comparison-of-automated-versus-semi-automated-software
#4
Nivin Sharawy, Ahmed Mukhtar, Sufia Islam, Reham Mahrous, Hassan Mohamed, Mohamed Ali, Amr Abd El Hakeem, Osama Hossny, Amera Refaa, Ahmed Saka, Vladimir Cerny, Sara Whynot, Ron George, Christian Lehmann
INTRODUCTION: The outcome of patients in septic shock has been shown to be related to changes within the microcirculation. Modern imaging technologies are available to generate high resolution video recordings of the microcirculation in humans. However, evaluation of the microcirculation is not yet implemented in the routine clinical monitoring of critically ill patients. This is mainly due to large amount of time and user interaction required by the current video analysis software. The aim of this study was to validate a newly developed automated method (CCTools®) for microcirculatory analysis of sublingual capillary perfusion in septic patients in comparison to standard semi-automated software (AVA3®)...
September 11, 2017: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/28919395/gastroprotective-effect-of-aucubin-against-ethanol-induced-gastric-mucosal-injury-in-mice
#5
Yang Yang, Bing Yin, Le Lv, Ziye Wang, Jiao He, Ziyang Chen, Xin Wen, Yongmin Zhang, Wenji Sun, Yang Li, Ye Zhao
AIMS: Aucubin, an iridoid glycoside, was isolated from seeds of Eucommia ulmoides Oliver. This study was aimed to evaluate the protective effect of aucubin against ethanol-induced gastric mucosal injury in mice. MATERIALS AND METHODS: Mice were orally administrated with aucubin (20, 40 and 80mg/kg) for 3 consecutive days. On the 3rd day, the mice of gastric mucosal injury were induced with 70% ethanol after the last administration of aucubin. Gastric tissue of mice were submitted for evaluating the severity of gastric mucosal injury...
September 14, 2017: Life Sciences
https://www.readbyqxmd.com/read/28919283/clinical-manifestations-risk-factors-and-prognosis-of-patients-with-morganella-morganii-sepsis
#6
David Erlanger, Marc Victor Assous, Yonit Wiener-Well, Amos Moshe Yinnon, Eli Ben-Chetrit
BACKGROUND: There are few studies of Morganella bacteremia. We evaluated risk factors and outcome of patients with Morganella bacteremia. METHODS: Medical records of patients with Morganella bacteremia were reviewed (1997-2014). Control group patients with Escherichiacoli sepsis were matched by year of diagnosis and infection acquisition site. RESULTS: The study group included 136 adult patients. Mean age and gender of study and control groups were similar...
September 6, 2017: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
https://www.readbyqxmd.com/read/28917560/outcomes-of-rescue-cardiopulmonary-support-for-periprocedural-acute-hemodynamic-decompensation-in-patients-undergoing-catheter-ablation-of-electrical-storm
#7
Andres Enriquez, Jackson Liang, Javier Gentile, Robert Schaller, Gregory Supple, David S Frankel, Fermin Garcia, Joyce Wald, Edo Y Birati, J Eduardo Rame, Christian Bermudez, David Callans, Francis Marchlinski, Pasquale Santangeli
BACKGROUND: In patients with ventricular tachycardia/fibrillation (VT/VF) electrical storm (ES) undergoing catheter ablation (CA), hypotension due to refractory VT/VF, use of anesthesia and cardiac stunning due to repeated ICD shocks might precipitate acute hemodynamic decompensation (AHD). OBJECTIVE: We evaluated the outcomes of emergent cardiopulmonary support with extracorporeal membrane oxygenation (ECMO) to rescue AHD in patients undergoing CA of ES. METHODS: Between 2010 and 2016, 21 patients with ES (VT in 11 and PVC-triggered VF in 10) were referred for CA and had periprocedural AHD requiring emergent ECMO support...
September 13, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28916877/bile-duct-injury-and-morbidity-following-cholecystectomy-a-need-for-improvement
#8
Meredith Barrett, Horacio J Asbun, Hung-Lung Chien, L Michael Brunt, Dana A Telem
BACKGROUND: Bile duct injury (BDI) remains the most dreaded complication following cholecystectomy with serious repercussions for the surgeon, patient and entire healthcare system. In the absence of registries, the true incidence of BDI in the United States remains unknown. We aim to identify the incidence of BDI requiring operative intervention and overall complications after cholecystectomy. METHODS: Utilizing the Truven Marketscan(®) research database, 554,806 patients who underwent cholecystectomy in calendar years 2011-2014 were identified using ICD-9 procedure and diagnosis codes...
September 15, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28916510/outcomes-of-telemedicine-video-conferencing-clinic-versus-in-person-clinic-follow-up-for-implantable-cardioverter-defibrillator-recipients
#9
Khidir Dalouk, Nainesh Gandhi, Peter Jessel, Karen MacMurdy, Ignatius Gerardo Zarraga, Michael Lasarev, Merritt Raitt
BACKGROUND: Implantable cardioverter-defibrillator (ICD) recipients require close follow-up that can be difficult for patients who have to travel long distances for clinic follow-up. We aimed to compare clinical outcomes between ICD patients followed-up in a telemedicine video-conferencing clinic (TMVC) and a conventional in-person clinic (CIC). We hypothesized that outcomes of patients followed in the TMVC are noninferior to the CIC. METHODS AND RESULTS: This retrospective study compares time to first appropriate ICD therapy, time to first inappropriate ICD therapy, time to first shock, and overall survival in patients followed in TMVC compared with CIC between 2001 and 2016...
September 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28904478/how-useful-is-extravascular-lung-water-measurement-in-managing-lung-injury-in-intensive-care-unit
#10
Anirban Bhattacharjee, Debasis Pradhan, Prithwis Bhattacharyya, Samarjit Dey, Daniala Chhunthang, Akash Handique, Angkita Barman, Mohd Yunus
CONTEXT: The primary goal of septic shock management is optimization of organ perfusion, often at the risk of overloading the interstitium and causing pulmonary edema. The conventionally used end points of resuscitation do not generally include volumetric parameters such as extravascular lung water index (EVLWI) and pulmonary vascular permeability index (PVPI). AIMS: This study aimed to assess the prognostic value of EVLWI and PVPI by calculating their correlation with the severity of lung injury...
August 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28903811/does-integration-matter-a-holistic-model-for-building-community-resilience-in-pakistan
#11
Shesh Kanta Kafle
This paper analyses an integrated communitybased risk reduction model adopted by the Pakistan Red Crescent. The paper analyses the model's constructs and definitions, and provides a conceptual framework and a set of practical recommendations for building community resilience. The study uses the process of outcome-based resilience index to assess the effectiveness of the approach. The results indicate that the integrated programming approach is an effective way to build community resilience as it offers a number of tangible and longlasting benefits, including effective and efficient service delivery, local ownership, sustainability of results, and improved local resilience with respect to the shock and stress associated with disaster...
January 1, 2017: Journal of Business Continuity & Emergency Planning
https://www.readbyqxmd.com/read/28891162/integrating-invasive-hemodynamic-parameters-into-risk-stratification-of-acute-myocardial-infarction-and-cardiogenic-shock
#12
EDITORIAL
Gennaro Giustino, George D Dangas
A ratio of systolic blood pressure over left ventricle end-diastolic pressure (SBP/LVEDP) ≤4 identifies patients with ST-elevation myocardial infarction (STEMI) at greater risk of in-hospital mortality or that may require the use of mechanical circulatory support (MCS). The predictive performance of the SBP/LVEDP ratio was comparable to non-invasive hemodynamic parameters (the shock index and the modified shock index) and established clinical risk stratification tools (the TIMI risk score). Alongside established clinical risk factors, invasive hemodynamic parameters may help in identifying STEMI patients who may benefit from early MCS...
September 1, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28887766/short-term-effects-of-passive-mobilization-on-the-sublingual-microcirculation-and-on-the-systemic-circulation-in-patients-with-septic-shock
#13
Tuanny Teixeira Pinheiro, Flávio Geraldo Rezende de Freitas, Karla Tuanny Fiorese Coimbra, Vanessa Marques Ferreira Mendez, Heloísa Baccaro Rossetti, Paulo Vinicius Talma, Antônio Tonete Bafi, Flávia Ribeiro Machado
BACKGROUND: Active mobilization is not possible in patients under deep sedation and unable to follow commands. In this scenario, passive therapy is an interesting alternative. However, in patients with septic shock, passive mobilization may have risks related to increased oxygen consumption. Our objective was to evaluate the impact of passive mobilization on sublingual microcirculation and systemic hemodynamics in patients with septic shock. METHODS: We included patients who were older than 18 years, who presented with septic shock, and who were under sedation and mechanical ventilation...
September 8, 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28887495/integration-of-deep-transcriptome-and-proteome-analyses-of-salicylic-acid-regulation-high-temperature-stress-in-ulva-prolifera
#14
Meihua Fan, Xue Sun, Nianjun Xu, Zhi Liao, Yahe Li, Jianxin Wang, Yingping Fan, Dalian Cui, Peng Li, Zengliang Miao
To investigate changes in transcript and relative protein levels in response to salicylic acid regulation of the thermotolerance in U. prolifera, complementary transcriptome and proteome analyses were performed with U. prolifera grown at 35 °C (UpHT) and with the addition of SA at high temperature (UpSHT). At mRNA level,12,296 differentially expressed genes (DEGs) were obtained from the comparison of UpSHT with UpHT. iTRAQ-labeling proteome analysis showed that a total of 4,449 proteins were identified and reliably quantified...
September 8, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28885956/combat-casualties-and-severe-shock-risk-factors-for-death-at-role-3-military-facilities
#15
Michelle F Buehner, Brian J Eastridge, James K Aden, Joseph J DuBose, Lorne H Blackbourne, Ramon F Cestero
BACKGROUND: Although significant research has been conducted on combat casualties receiving blood products, there is limited data for the subpopulation presenting in shock. The purpose of this study was to evaluate combat casualties arriving to a role 3 facility with an initial systolic blood pressure (SBP) ≤ 90 in order to identify clinical characteristics and associations between presentation, transfusion therapy, and mortality outcomes. METHODS: The Department of Defense Trauma Registry was queried from 2001 to 2010 for trauma-related casualties who arrived at a role 3 combat surgical facility with a SBP ≤ 90...
September 2017: Military Medicine
https://www.readbyqxmd.com/read/28885470/poor-microcirculatory-flow-dynamics-are-associated-with-endothelial-cell-damage-and-glycocalyx-shedding-following-traumatic-hemorrhagic-shock
#16
David N Naumann, Jon Hazeldine, Mark J Midwinter, Sam D Hutchings, Paul Harrison
BACKGROUND: Endothelial cell damage and glycocalyx shedding following trauma can increase the risk of inflammation, coagulopathy, vascular permeability and death. Bedside sublingual video-microscopy may detect worse flow and perfusion associated with this endotheliopathy. We compared markers of endotheliopathy with physical flow dynamics following traumatic hemorrhagic shock (THS). METHODS: Sublingual incident dark field video-microscopy was performed at three time-points following injury (<10h; 10-30h; and 30-50h)...
September 5, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28881451/validation-of-a-pediatric-early-warning-system-for-hospitalized-pediatric-oncology-patients-in-a-resource-limited-setting
#17
Asya Agulnik, Alejandra Méndez Aceituno, Lupe Nataly Mora Robles, Peter W Forbes, Dora Judith Soberanis Vasquez, Ricardo Mack, Federico Antillon-Klussmann, Monica Kleinman, Carlos Rodriguez-Galindo
BACKGROUND: Pediatric oncology patients are at high risk of clinical deterioration, particularly in hospitals with resource limitations. The performance of pediatric early warning systems (PEWS) to identify deterioration has not been assessed in these settings. This study evaluates the validity of PEWS to predict the need for unplanned transfer to the pediatric intensive care unit (PICU) among pediatric oncology patients in a resource-limited hospital. METHODS: A retrospective case-control study comparing the highest documented and corrected PEWS score before unplanned PICU transfer in pediatric oncology patients (129 cases) with matched controls (those not requiring PICU care) was performed...
September 7, 2017: Cancer
https://www.readbyqxmd.com/read/28880400/effects-of-ivermectin-and-its-combination-with-alpha-lipoic-acid-on-expression-of-igfbp-3-and-hspa1-genes-and-male-rat-fertility
#18
Z K El-Maddawy, W S H Abd El Naby
This study was conducted to evaluate the effects of ivermectin (IVM) with therapeutic dose (injected with 0.56 mg/kg b.wt.) either alone or combined with alpha lipoic acid (ALA) (50 mg/kg b.wt daily) on expression of testicular insulin-like growth factor binding protein-3 (IGFBP-3) and heat-shock protein A1 (HSPA1)) genes in the testes, as well as on male rat fertility parameters. Results revealed that expression levels of IGFBP-3 and HSPA1 were significantly increased in testis of the IVM-treated group relative to the control group...
September 7, 2017: Andrologia
https://www.readbyqxmd.com/read/28879449/prognostic-factors-of-mortality-in-iranian-patients-with-systemic-lupus-erythematosus-admitted-to-intensive-care-unit
#19
Alimohammad Fatemi, Somayeh Shamsaee, Ahmad Raeisi, Zahra Sayedbonakdar, Abbas Smiley
The aim was to determine the course, outcome, and determinants of mortality in patients with systemic lupus erythematosus (SLE) in intensive care unit (ICU). SLE patients admitted to ICU from 2004 to 2015 were recruited retrospectively. Demographic data, disease characteristics, causes of admission, baseline SLE disease activity index-2K (SLEDAI-2K) and Acute Physiologic and Chronic Health Evaluation II (APACHE) score, the outcome, and the causes of death were recorded. Predictors of mortality were compared between alive and dead patients by Cox regression analysis...
September 6, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28876571/duodenectomy-managing-the-fistula
#20
M Govender, O Matsevych, F Ghoor, N Singh, C Molenaar
BACKGROUND: Duodenectomy is rarely indicated, however, in certain circumstances may have be performed. Enterocutaneous fistula (ECF) is the main cause of serious adverse outcomes. Its management remains challenging. METHOD: Two cases of emergency duodenectomy are presented. The management of ECF is described and discussed. RESULTS: Case 1: A 22-year-old male presented in septic shock with perforated duodenal ulcer, suffered two cardiac arrests before index surgery...
September 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
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