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https://www.readbyqxmd.com/read/28643979/-acute-pancreatitis-new-aspects-for-the-management
#1
Olivier Windisch, Toni Raffoul, Catrina Hansen, Jean-Louis Frossard, Philippe Morel, Léo Bühler
Acute pancreatitis is a frequent disease, with a simple course in 80 % of the cases but a high morbidity and mortality in its severe form. Biliary origin and alcohol represent 80 % of the etiologies. Except endoscopic removal of gallstone for biliary origin, treatment remains symptomatic and focuses on fluid resuscitation, effective antalgia and adapted management of nutrition. This article focuses on the novelties introduced by the revision of the Classification of Atlanta in 2012 and details current guidelines for the management of the disease...
June 14, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28642485/sphingosine-1-phosphate-treatment-can-ameliorate-microvascular-leakage-caused-by-combined-alcohol-intoxication-and-hemorrhagic-shock
#2
Travis M Doggett, Natascha G Alves, Sarah Y Yuan, Jerome W Breslin
Fluid resuscitation following hemorrhagic shock is often problematic, with development of prolonged hypotension and edema. In addition, many trauma patients are also intoxicated, which generally worsens outcomes. We directly investigated how alcohol intoxication impacts hemorrhagic shock and resuscitation-induced microvascular leakage using a rat model with intravital microscopic imaging. We also tested the hypothesis that an endothelial barrier-protective bioactive lipid, sphingosine-1-phosphate (S1P), could ameliorate the microvascular leakage following alcohol intoxication plus hemorrhagic shock and resuscitation...
June 22, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28640781/hydrogen-gas-inhalation-inhibits-progression-to-the-irreversible-stage-of-shock-after-severe-hemorrhage-in-rats
#3
Tadashi Matsuoka, Masaru Suzuki, Motoaki Sano, Kei Hayashida, Tomoyoshi Tamura, Koichiro Homma, Keiichi Fukuda, Junichi Sasaki
BACKGROUND: Mortality of hemorrhagic shock primarily depends on whether or not the patients can endure the loss of circulating volume until radical treatment is applied. We investigated whether hydrogen (H2) gas inhalation would influence the tolerance to hemorrhagic shock and improve survival. METHODS: Hemorrhagic shock was achieved by withdrawing blood until the mean arterial blood pressure reached 30-35 mmHg. After 60 minutes of shock, the rats were resuscitated with a volume of normal saline equal to four times the volume of shed blood...
June 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28633090/pulmonary-and-cardiac-pathology-in-sudden-unexpected-death-in-epilepsy-sudep
#4
REVIEW
Fábio A Nascimento, Zian H Tseng, Cristian Palmiere, Joseph J Maleszewski, Takayuki Shiomi, Aileen McCrillis, Orrin Devinsky
OBJECTIVE: To review studies on structural pulmonary and cardiac changes in SUDEP cases as well as studies showing pulmonary or cardiac structural changes in living epilepsy patients. METHODS: We conducted electronic literature searches using the PubMed database for articles published in English, regardless of publication year, that included data on cardiac and/or pulmonary structural abnormalities in SUDEP cases or in living epilepsy patients during the postictal period...
June 17, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28630388/spontaneous-liver-rupture-associated-with-anticoagulant-therapy-a-case-report
#5
Marco Clementi, Sara Colozzi, Stefano Guadagni, Beatrice Pessia, Federico Sista, Mario Schietroma, Andrea Della Penna, Gianfranco Amicucci
Spontaneous hepatic rupture without underlying liver diseases is uncommon entity. We report a rare case of spontaneous rupture of liver hematoma in patient treated with warfarin end enoxaparin sodium because of pulmonary embolism. Two day after admission the patient complained generalized abdominal pain and hemodynamic instability. The abdominal US and TC scan revealed free fluid and lesion at right liver lobe. The patient, despite intravenous fluid support and blood transfusion, was hemodinamically instable and urgent laparotomy was needed...
January 20, 2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/28630246/ominous-triad-triggered-by-high-dose-glucocorticosteroid-therapy
#6
Sarah Bär, Fritz Daudel, Thomas Zueger
Glucocorticosteroids (CS) play a key role in the treatment of numerous diseases. Nonetheless, they can be accompanied by several adverse effects. We present the case of a 51-year-old woman who was treated with high-dose CS for a relapse of her multiple sclerosis. After 5 days of treatment, the patient developed severe diabetic ketoacidosis, hypertriglyceridemia and acute pancreatitis-a potentially life-threatening triad which has previously been described, in our case, however, for the first time as a complication of CS therapy...
June 18, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28629957/chemical-hand-warmer-packet-ingestion-a-case-of-elemental-iron-exposure
#7
Jessica L Weiland, Leighanne K Sherrow, Deepak A Jayant, Kenneth D Katz
For individuals who work outdoors in the winter or play winter sports, chemical hand warmers are becoming increasingly more commonplace because of their convenience and effectiveness. A 32-year-old woman with a history of chronic pain and bipolar disorder presented to the emergency department complaining of a "warm sensation" in her mouth and epigastrium after reportedly ingesting the partial contents of a chemical hand warmer packet containing between 5 and 8 g of elemental iron. She had been complaining of abdominal pain for approximately 1 month and was prescribed unknown antibiotics the previous day...
June 16, 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28627649/hypoxia-serves-a-key-function-in-the-upregulated-expression-of-vascular-adhesion-protein%C3%A2-1-in%C3%A2-vitro-and-in-a-rat-model-of-hemorrhagic-shock
#8
Yuxing Zhang, Wei Yi, Jun Yao, Xiaojun Yu, Cheng Qian, Zhiqian Hu
Hemorrhagic shock following major trauma results in mortality, but the function of vascular adhesion protein‑1 (VAP‑1), implicated in intracranial hemorrhage, remains unknown. This study aimed to determine whether expression of the AOC3 gene and its encoded protein, VAP‑1, is altered by hypoxia. Rat hepatic sinusoidal endothelial cells (RHSECs) and rat intestinal microvascular endothelial cells (RIMECs) were transduced with a viral vector carrying AOC3, and AOC3 mRNA expression levels were measured by reverse transcription‑quantitative polymerase chain reaction...
June 8, 2017: Molecular Medicine Reports
https://www.readbyqxmd.com/read/28625256/-comparison-of-effect-of-norepinephrine-and-terlipressin-on-patients-with-ards-combined-with-septic-shock-a-prospective-single-blind-randomized-controlled-trial
#9
Zhi Chen, Ping Zhou, Yuanhua Lu, Chunli Yang
OBJECTIVE: To approach the effect of different vasopressor on hemodynamics, volume responsiveness, fluid volume balance, renal function and prognosis in patients with acute respiratory distress syndrome (ARDS) complicated with septic shock. METHODS: A prospective single-blind randomized controlled trial was conducted. ARDS patients with septic shock admitted to the Department of Critical Care Medicine of Jiangxi Provincial People's Hospital from January 1st, 2015 to May 1st, 2016 were enrolled...
February 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28625234/-effect-of-global-end-diastolic-volume-index-guidance-fluid-resuscitation-in-elderly-patients-with-septic-shock
#10
Shuang Ma, Rumin Zhang, Shifu Wang, Meiling Zhao, Lei Wang, Yun Zhang
OBJECTIVE: To evaluate the effect of global end diastolic volume index (GEDVI) on fluid resuscitation in elderly patients with septic shock. METHODS: A prospective randomized controlled trial (RCT) was conducted. Septic shock patients over 65 years admitted to intensive care unit (ICU) of Shandong Province, Zibo Central Hospital from January 2013 to December 2015 were enrolled. The patients were randomly divided into control group and observation group, 20 cases in each group...
June 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28617696/should-hyperoxia-be-avoided-during-sepsis-an-experimental-study-in-ovine-peritonitis
#11
Xinrong He, Fuhong Su, Keliang Xie, Fabio Silvio Taccone, Katia Donadello, Jean-Louis Vincent
OBJECTIVES: Optimizing oxygen delivery is an important part of the hemodynamic resuscitation of septic shock, but concerns have been raised over the potentially deleterious effects of hyperoxia. We evaluated the impact of hyperoxia on hemodynamics, the microcirculation, and cerebral and renal metabolism in an ovine model of septic shock. DESIGN: Randomized animal study. SETTING: University hospital animal research laboratory. SUBJECTS: Fourteen adult female sheep...
June 14, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28616838/assessment-of-renal-hemodynamic-toxicity-of-fluid-challenge-with-0-9-nacl-compared-to-balanced-crystalloid-plasmalyte-%C3%A2-in-a-rat-model-with-severe-sepsis
#12
Pierre-Yves Olivier, François Beloncle, Valérie Seegers, Maher Tabka, Mathilde Renou de La Bourdonnaye, Alain Mercat, Paul Cales, Daniel Henrion, Peter Radermacher, Lise Piquilloud, Nicolas Lerolle, Pierre Asfar
BACKGROUND: According to international guidelines, volume expansion with crystalloids is the first-line treatment for hemodynamic management in patients with severe sepsis or septic shock. Compared to balanced crystalloids, 0.9% sodium chloride (0.9% NaCl) induces hyperchloremia and metabolic acidosis and may alter renal hemodynamics and function. We compared the effects of 0.9% NaCl to a less chloride-concentrated fluid, PlasmaLyte(®) (PL) in targeted fluid resuscitation in a randomized, double-blind controlled study in an experimental model of severe sepsis in rats...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28616241/passive-leg-raising-test-with-minimally-invasive-monitoring-the-way-forward-for-guiding-septic-shock-resuscitation
#13
Patrick M Honore, Herbert D Spapen
BACKGROUND: Swift and adequate fluid loading is a cornerstone of septic shock therapy. Yet, careful assessment of volume responsiveness and volume amount during the resuscitation process is a prerequisite. Both overzealous initial fluid administration and late fluid overload are harmful and may be associated with increased mortality. MAIN BODY: Static (i.e., central venous or pulmonary artery occlusion) pressure readings are erroneous for monitoring fluid resuscitation and should be abandoned...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28615900/predictors-of-outcome-in-children-with-status-epilepticus-during-resuscitation-in-pediatric-emergency-department-a-retrospective-observational-study
#14
Indumathy Santhanam, Sangeetha Yoganathan, V Akila Sivakumar, Rubini Ramakrishnamurugan, Sharada Sathish, Murali Thandavarayan
OBJECTIVES: To study the clinical profile and predictors of outcome in children with status epilepticus (SE) during resuscitation in pediatric emergency department. MATERIALS AND METHODS: This retrospective study was carried out in a tertiary care teaching hospital. Admission and resuscitation data of children, aged between 1 month and 12 years, treated for SE, between September 2013 and August 2014, were extracted using a standard data collection form. Our SE management protocol had employed a modified pediatric assessment triangle to recognize and treat acute respiratory failure, cardiovascular dysfunction (CD), and subtle SE until all parameters resolved...
April 2017: Annals of Indian Academy of Neurology
https://www.readbyqxmd.com/read/28615115/circulatory-collapse-in-a-parturient-undergoing-cesarean-delivery-a-diagnostic-dilemma
#15
M M Tawfik, M E Taman, A I Tarbay, M Sayed, K A Awad
Embolic events including thromboembolism, air embolism, and amniotic fluid embolism can cause cardiovascular collapse during cesarean delivery. Differentiation between the three conditions is challenging because they share many of the initial clinical and echocardiographic findings, but an accurate, definitive diagnosis allows the administration of specific therapy that may help in saving the life of the mother and/or the fetus. We report a case of cardiovascular collapse during cesarean delivery under general anesthesia; massive pulmonary thromboembolism was suspected and unfractionated heparin was administered...
May 10, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28612932/prehospital-parameters-can-help-to-predict-coagulopathy-and-massive-transfusion-in-trauma-patients
#16
J-S David, E-J Voiglio, E Cesareo, O Vassal, E Decullier, P-Y Gueugniaud, S Peyrefitte, K Tazarourte
BACKGROUND: This study aimed to evaluate the accuracy of prehospital parameters, including vital signs and resuscitation (fluids, vasopressor), to predict trauma-induced coagulopathy (TIC, fibrinogen <1·5 g/l or PTratio > 1·5 or platelet count <100 × 10(9) /l), and a massive transfusion (MT, ≥10 RBC units within the first 24 h). METHODS: From a trauma registry (2011-2015), in which patients are prospectively included, we retrospectively retrieved the heart rate (HR), systolic blood pressure (SBP), volume of prehospital fluids and administration of noradrenaline...
June 14, 2017: Vox Sanguinis
https://www.readbyqxmd.com/read/28601484/resuscitation-using-less-fluid-has-no-negative-impact-on-hydration-status-in-children-with-moderate-sized-scalds-a-prospective-single-centre-uk-study
#17
Linda Hollén, Karen Coy, Andrew Day, Amber Young
BACKGROUND: After a burn, optimal fluid resuscitation is critical for positive patient outcome. Although national guidelines advocate using resuscitation fluids of 4mL per kg body weight and percent body surface area (%BSA) for paediatric burns of >10% BSA, evidence in adults suggest that such volumes lead to over-resuscitation and related complications. Our aim was to investigate whether children managed with biosynthetic dressings (Biobrane™) and reduced fluid volumes remain well hydrated, as determined by clinical and laboratory parameters...
June 7, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28601304/a-practical-guide-for-small-bowel-transplantation-in-rats-review-of-techniques-and-models
#18
REVIEW
Daniel Foell, Felix Becker, Rebecca Hadrian, Daniel Palmes, Linus Kebschull
BACKGROUND: Animal models are a central aspect in research on small bowel transplantation (SBTx). Among them, rats are the preferred species because of their widespread availability and cost effectiveness. Because the complexity of the surgical procedure could per se influence the outcome of an experiment, a standardized and comparable technique is important. Based on of the vast amount of different models and surgical techniques published to this point, a review seemed necessary to guide investigators when choosing the suitable model...
June 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28601214/fluid-resuscitation-in-tactical-combat-casualty-care-yesterday-and-today
#19
REVIEW
Frank K Butler
The prevailing wisdom for the prehospital fluid resuscitation of trauma victims in hemorrhagic shock in 1992 was to administer 2 L of crystalloid solution as rapidly as possible. A review of the fluid resuscitation literature found that this recommendation was not well supported by the evidence at the time. Prehospital fluid resuscitation strategies were reevaluated in the 1993-1996 Tactical Combat Casualty Care (TCCC) research program. This article reviews the advances in prehospital fluid resuscitation as recommended by the original TCCC Guidelines and modified over the following 2 decades...
June 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28601205/remote-damage-control-resuscitation-in-austere-environments
#20
REVIEW
Ronald Chang, Brian J Eastridge, John B Holcomb
Hemorrhage is the leading cause of preventable military and civilian trauma death. Damage control resuscitation with concomitant mechanical hemorrhage control has become the preferred in-hospital treatment of hemorrhagic shock. In particular, plasma-based resuscitation with decreased volumes of crystalloids and artificial colloids as part of damage control resuscitation has improved outcomes in the military and civilian sectors. However, translation of these principles and techniques to the prehospital, remote, and austere environments, known as remote damage control resuscitation, is challenging given the resource limitations in these settings...
June 2017: Wilderness & Environmental Medicine
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