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https://www.readbyqxmd.com/read/29142955/improving-the-prediction-of-cardiac-surgery-associated-acute-kidney-injury
#1
Jordan Crosina, Jordyn Lerner, Julie Ho, Navdeep Tangri, Paul Komenda, Brett Hiebert, Nora Choi, Rakesh C Arora, Claudio Rigatto
Introduction: Acute kidney injury (AKI) is a potentially fatal complication of cardiac surgery. The inability to predict cardiac surgery-associated AKI is a major barrier to prevention and early treatment. Current clinical risk models for the prediction of cardiac surgery-associated AKI are insufficient, particularly in patients with preexisting kidney dysfunction. Methods: To identify intraoperative variables that might improve the performance of a validated clinical risk score (Cleveland Clinic Score, CCS) for the prediction of cardiac surgery-associated AKI, we conducted a prospective cohort study in 289 consecutive elective cardiac surgery patients at a tertiary care center...
March 2017: KI Reports
https://www.readbyqxmd.com/read/29140136/salt-glycerol-induced-hyperhydration-enhances-fluid-retention-more-than-salt-or-glycerol-induced-hyperhydration
#2
Eric D B Goulet, Adrien De La Flore, Félix A Savoie, Jonathan Gosselin
Hyperhydration has been demonstrated to improve work capacity and cardiovascular and thermoregulatory functions, enhance orthostatic tolerance, slow or neutralize bone demineralization and decrease post-dive bubble formation. Adding sodium or glycerol to a hyperhydration solution optimizes fluid retention. Sodium and glycerol produce their effect through different physiological mechanisms. If combined into a hyperhydration solution their impact on fluid retention could potentially be greater than their singular effect...
November 15, 2017: International Journal of Sport Nutrition and Exercise Metabolism
https://www.readbyqxmd.com/read/29137593/central-pontine-myelinolysis-after-living-donor-liver-transplant-a-report-of-2-cases
#3
Ya-Lan Hsu, Chia-En Hsieh, Kuo-Hua Lin, Chen-Te Chou, Ping-Yi Lin, Su-Han Wang, Yao-Li Chen
Here, we present 2 patients who developed central pontine myelinolysis after living-donor liver transplant. Both patients had abnormal sodium level before living-donor liver transplant. Patient 1 presented with severe hyponatremia on admission. After administration of 3% saline, her sodium level during the first 24 hours was kept at 100 mEq/L and then increased to 116 mEq/L during the next 24 hours. The level increased 5.8 mEq/L during the 4- to 5-hour transplant procedure. Patient 2 was admitted to the hospital with an unprovoked seizure...
November 15, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/29137585/association-of-positive-fluid-balance-and-mortality-in-sepsis-and-septic-shock-in-an-australian-cohort
#4
M G Pittard, S J Huang, A S McLean, S R Orde
In patients with septic shock, a correlation between positive fluid balance and worsened outcomes has been reported in multiple observational studies worldwide. No published data exists in an Australasian cohort. We set out to explore this association in our institution. We conducted a retrospective audit of patient records from August 2012 to May 2015 in a single-centre, 24-bed surgical and medical intensive care unit (ICU) in Sydney, Australia. All patients with septic shock were included. Exclusion criteria included length of stay less than 24 hours or vasopressors needed for less than six hours...
November 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29136192/assessing-the-hydration-status-of-children-with-chronic-kidney-disease-and-on-dialysis-a-comparison-of-techniques
#5
Caroline S Y Eng, Devina Bhowruth, Mark Mayes, Lynsey Stronach, Michelle Blaauw, Amy Barber, Lesley Rees, Rukshana C Shroff
Background: Fluid balance is pivotal in the management of children with chronic kidney disease (CKD) and on dialysis. Although many techniques are available to assess fluid status, there are only a few studies for children, of which none have been comparable against cardiovascular outcome measures. Methods: We performed a longitudinal study in 30 children with CKD5-5D and 13 age-matched healthy controls (71 measurements) to determine a correlation between optimal weight by bioimpedance spectroscopy (Wt-BIS) and clinical assessment (Wt-CA)...
November 9, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29136013/monomer-conversion-dimensional-stability-strength-modulus-surface-apatite-precipitation-and-wear-of-novel-reactive-calcium-phosphate-and-polylysine-containing-dental-composites
#6
Kanokrat Kangwankai, Sarah Sani, Piyaphong Panpisut, Wendy Xia, Paul Ashley, Haralampos Petridis, Anne Margaret Young
PURPOSE: The aim was to assess monomer conversion, dimensional stability, flexural strength / modulus, surface apatite precipitation and wear of mono / tri calcium phosphate (CaP) and polylysine (PLS)-containing dental composites. These were formulated using a new, high molecular weight, fluid monomer phase that requires no polymerisation activator. MATERIALS AND METHODS: Urethane and Polypropylene Glycol Dimethacrylates were combined with low levels of an adhesion promoting monomer and a light activated initiator...
2017: PloS One
https://www.readbyqxmd.com/read/29135526/case-report-of-an-awake-craniotomy-in-a-patient-with-eisenmenger-syndrome
#7
Boris D Heifets, Erin Crawford, Ethan Jackson, Jessica Brodt, Richard A Jaffe, Mark A Burbridge
We present a detailed report of an awake craniotomy for recurrent third ventricular colloid cyst in a patient with severe pulmonary arterial hypertension in the setting of Eisenmenger syndrome, performed 6 weeks after we managed the same patient for a more conservative procedure. This patient has a high risk of perioperative mortality and may be particularly susceptible to perioperative hemodynamic changes or fluid shifts. The risks of general anesthesia induction and emergence must be balanced against the risks inherent in an awake craniotomy on a per case basis...
November 9, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/29132208/organic-chemical-characterization-and-mass-balance-of-a-hydraulically-fractured-well-from-fracturing-fluid-to-produced-water-over-405-days
#8
James S Rosenblum, E Michael Thurman, Imma Ferrer, George R Aiken, Karl G Linden
A long-term field study (405 days) of a hydraulically fractured well from the Niobrara Formation in the Denver-Julesburg Basin was completed. Characterization of organic chemicals used in hydraulic fracturing and their changes through time, from the pre-injected fracturing fluid to the produced water, was conducted. The characterization consisted of a mass balance by dissolved organic carbon (DOC), volatile organic analysis by gas chromatography/mass spectrometry, and nonvolatile organic analysis by liquid chromatography/mass spectrometry...
November 14, 2017: Environmental Science & Technology
https://www.readbyqxmd.com/read/29130606/oral-administration-of-lactobacillus-plantarum-cjlp133-and-cjlp243-alleviates-birch-pollen-induced-allergic-rhinitis-in-mice
#9
S-P Choi, H-N Oh, C-Y Choi, H Ahn, H S Yun, Y M Chung, B Kim, S J Lee, T Chun
AIMS: In this study, we evaluated the therapeutic efficacy of selected probiotics in a mouse model of birch pollen (BP)-induced allergic rhinitis. METHODS AND RESULTS: Oral administration of lactobacillus plantarum CJLP133 and CJLP243 ameliorated the symptoms of BP-induced allergic rhinitis by reducing airway hyperresponsiveness (AHR), and both the histological scores and the number of infiltrated cells in the nasal cavities and lungs. Compared with those from vehicle-treated mice, bronchoalveolar lavage (BAL) fluid and draining lymph node samples from CJLP133 and CJLP243-administrated mice showed diminished numbers of immune cells, increased secretion of a Th1-type cytokine (IFN-γ), and decreased production of Th2-type cytokines (IL-4, IL-5 and IL-13)...
November 12, 2017: Journal of Applied Microbiology
https://www.readbyqxmd.com/read/29129925/the-neural-basis-of-homeostatic-and-anticipatory-thirst
#10
REVIEW
Claire Gizowski, Charles W Bourque
Water intake is one of the most basic physiological responses and is essential to sustain life. The perception of thirst has a critical role in controlling body fluid homeostasis and if neglected or dysregulated can lead to life-threatening pathologies. Clear evidence suggests that the perception of thirst occurs in higher-order centres, such as the anterior cingulate cortex (ACC) and insular cortex (IC), which receive information from midline thalamic relay nuclei. Multiple brain regions, notably circumventricular organs such as the organum vasculosum lamina terminalis (OVLT) and subfornical organ (SFO), monitor changes in blood osmolality, solute load and hormone circulation and are thought to orchestrate appropriate responses to maintain extracellular fluid near ideal set points by engaging the medial thalamic-ACC/IC network...
November 13, 2017: Nature Reviews. Nephrology
https://www.readbyqxmd.com/read/29128962/good-response-to-tolvaptan-shortens-hospitalization-in-patients-with-congestive-heart-failure
#11
Tomohito Kogure, Kentaro Jujo, Kazuyuki Hamada, Katsumi Saito, Nobuhisa Hagiwara
Tolvaptan has been gradually spread to use as a potent diuretic for congestive heart failure in the limited country. However, the response to this aquaretic drug still is unpredictable. A total of 92 patients urgently hospitalized due to congestive heart failure and treated with tolvaptan in addition to standard treatment was retrospectively analyzed. Responder of tolvaptan treatment was defined as a patient with peak negative fluid balance greater than 500 mL/day, and clinical profiles were compared between 76 responders and 16 non-responders...
November 11, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/29123557/defining-fluid-removal-in-the-intensive-care-unit-a-national-and-international-survey-of-critical-care-practice
#12
Michael E O'Connor, Sarah L Jones, Neil J Glassford, Rinaldo Bellomo, John R Prowle
Design and objectives: To identify and compare how intensive care unit specialists in the United Kingdom and Australia and New Zealand self-reportedly define, assess and manage fluid overload in critically ill patients using a structured online questionnaire. Results: We assessed 219 responses. Australia and New Zealand and United Kingdom intensive care unit specialists reported using clinical examination findings, bedside tools and radiological features to assess fluid status, diagnose fluid overload and initiate fluid removal in the critically ill...
November 2017: J Intensive Care Soc
https://www.readbyqxmd.com/read/29122962/frequent-drinking-of-small-volumes-improves-cardiac-function-and-survival-in-rats-with-chronic-heart-failure
#13
Can Zheng, Meihua Li, Toru Kawada, Masashi Inagaki, Kazunori Uemura, Masaru Sugimachi
Fluid retention is the main reason for the high hospitalization rate among patients with chronic heart failure (CHF). Given the lack of knowledge about fluid intake regulation and its consequences in patients with CHF, current guidelines do not provide clear direction for fluid management. Using a rat model of CHF, we investigated altering drinking behaviors and explored fluid management strategies. CHF was induced by ligating the left anterior descending coronary arteries in 8-week-old, male, Sprague-Dawley rats...
November 2017: Physiological Reports
https://www.readbyqxmd.com/read/29122627/glial-function-and-dysfunction-in-the-normal-ischemic-brain
#14
REVIEW
Shino D Magaki, Christopher K Williams, Harry V Vinters
Astrocytes are the most abundant cell type in the central nervous system (CNS). Once considered to be of fairly homogeneous phenotype throughout the brain and spinal cord, they are now understood to be heterogeneous in both structure and function. They are important in brain functions as diverse as ion and fluid balance in the interstitial space, contributing to integrity of the neurovascular unit (blood-brain barrier), neurotransmitter regulation, metabolism of energy substrates and possibly even axonal regeneration...
November 6, 2017: Neuropharmacology
https://www.readbyqxmd.com/read/29122209/choice-of-fluids-in-the-perioperative-period-of-kidney-transplantation
#15
Alejandro Gonzalez-Castro, María Ortiz-Lasa, Yhivian Peñasco, Camilo González, Carmen Blanco, Juan Carlos Rodriguez-Borregan
Normal saline has traditionally been the resuscitation fluid of choice in the perioperative period of kidney transplantation over balanced potassium solutions. However, the problems arising from hyperchloraemia triggered by the infusion of normal saline have led to studies being conducted that compare this solution with balanced solutions. From this narrative review it can be concluded that the use of balanced crystalloids containing potassium in the perioperative period of kidney transplantation can be considered safe...
November 2017: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
https://www.readbyqxmd.com/read/29121319/should-we-use-hypotonic-or-isotonic-maintenance-intravenous-fluids-in-sick-patients-why-a-study-in-healthy-volunteers-will-not-provide-the-answer-response-to-effect-of-isotonic-versus-hypotonic-maintenance-fluid-therapy-on-urine-output-fluid-balance-and-electrolyte
#16
https://www.readbyqxmd.com/read/29120962/endothelial-factors-in-the-pathogenesis-and-treatment-of-chronic-kidney-disease-part-i-general-mechanisms-a-joint-consensus-statement-from-the-european-society-of-hypertension-working-group-on-endothelin-and-endothelial-factors-and-the-japanese-society-of-hypertension
#17
Gian Paolo Rossi, Teresa M Seccia, Matthias Barton, A H Jan Danser, Peter W de Leeuw, Neeraj Dhaun, Damiano Rizzoni, Patrick Rossignol, Luis-Miguel Ruilope, Anton H van den Meiracker, Sadayoshi Ito, Naoyuki Hasebe, David J Webb
: Kidney damage is a common consequence of arterial hypertension, but is also a cause of atherogenesis. Dysfunction and/or harm of the endothelium in glomeruli and tubular interstitium damage the function of these structures and translates into dynamic changes of filtration fraction, with progressive reduction in glomerular filtration rate, expansion of extracellular fluid volume, abnormal ion balance, and hypoxia, ultimately leading to chronic kidney disease. Considering the key role played by endothelial dysfunction in chronic kidney disease, the Working Group on Endothelin and Endothelial Factors of the European Society of Hypertension and the Japanese Society of Hypertension have critically reviewed available knowledge on the mechanisms underlying endothelial cell injury...
November 7, 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/29119728/a-framework-for-designing-patient-specific-bioprosthetic-heart-valves-using-immersogeometric-fluid-structure-interaction-analysis
#18
Fei Xu, Simone Morganti, Rana Zakerzadeh, David Kamensky, Ferdinando Auricchio, Alessandro Reali, Thomas J R Hughes, Michael S Sacks, Ming-Chen Hsu
Numerous studies have suggested that medical image derived computational mechanics models could be developed to reduce mortality and morbidity due to cardiovascular diseases by allowing for patient-specific surgical planning and customized medical device design. In this work, we present a novel framework for designing prosthetic heart valves using a parametric design platform and immersogeometric fluid-structure interaction (FSI) analysis. We parameterize the leaflet geometry using several key design parameters...
November 9, 2017: International Journal for Numerical Methods in Biomedical Engineering
https://www.readbyqxmd.com/read/29119469/learning-to-prescribe-intravenous-fluids-a%C3%A2-scoping-review
#19
REVIEW
Richard F R McCrory, Gerard Joseph Gormley, Alexander Peter Maxwell, Tim Dornan
INTRODUCTION: Prescribing intravenous (IV) fluid therapy is a core skill expected of qualified doctors at the point of graduation, but medical graduates often feel ill-equipped to perform this task. This lack of preparedness contributes to treatment-related patient harm. This scoping review maps the current state of published evidence about how junior doctors prescribe IV fluid therapy and learn how to do it. METHODS: We searched five electronic databases and grey literature from 1994 until June 2016 for articles describing any aspect of IV fluid prescribing practice or its education...
November 8, 2017: Perspectives on Medical Education
https://www.readbyqxmd.com/read/29110799/acute-postoperative-management-after-lung-transplantation
#20
REVIEW
Christopher Potestio, Desmond Jordan, Bessie Kachulis
Despite many advances in the field of lung transplantation, lung transplant recipients have the lowest median survival of any solid organ transplant population. Complications such as reperfusion injury, graft rejection, infection, and anastomotic breakdown increase morbidity and mortality during the immediate postoperative period. Ventilator management with lung protective strategies can not only minimize ventilator time and mitigate the risk of ventilator-associated pneumonia, but it may also decrease the risk of primary graft dysfunction and graft failure...
June 2017: Best Practice & Research. Clinical Anaesthesiology
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