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https://www.readbyqxmd.com/read/27907960/multimodality-monitoring-illuminating-the-comatose-human-brain
#1
Charles L Francoeur, Margaret Pain, Stephan A Mayer
The field of neurocritical care has evolved tremendously in recent years, a development explained vastly by the advent of neurophysiological monitoring. From basic intracranial pressure measurements to brain tissue oxygenation, microdialysis, cerebral blood flow (CBF), and surface and intracortical electroencephalography (EEG), our ability to detect and control physiologic endpoints of brain function in comatose patients has grown substantially. The integration of these data gave birth to the concept of multimodality monitoring (MMM)...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27881199/intestinal-permeability-induced-by-lipopolysaccharide-and-measured-by-lactulose-rhamnose-and-mannitol-sugars-in-chickens
#2
S Gilani, G S Howarth, S M Kitessa, C D Tran, R E A Forder, R J Hughes
Increased intestinal permeability (IP) can lead to compromised health. Limited in vivo IP research has been conducted in chickens. The objectives of the current study were to develop a model of increased IP utilizing lipopolysaccharide (LPS Escherichia coli O55:B5) and to evaluate IP changes using the lactulose, mannitol and rhamnose (LMR) sugar permeability test. In addition, fluorescein isothiocyanate dextran (FITC-d), d-lactate, zonula occludens (ZO-1) and diamine oxidase (DAO) permeability tests were employed...
November 24, 2016: Animal: An International Journal of Animal Bioscience
https://www.readbyqxmd.com/read/27867135/comparison-of-capillary-and-arterial-lactate-levels-in-patients-with-shock
#3
Olivier Collange, Vincent Garcia, Michel Kindo, Nicolas Meyer, Thomas Lavaux, Paul Michel Mertes, Girish P Joshi, Pierre Diemunsch
OBJECTIVE: Several guidelines recommend point-of-care lactate measurements for therapeutic decision-making in patients with shock. The aim of the study was to validate capillary lactate measurements with a bedside micromethod in patients with shock. STUDY DESIGN: Prospective observational study. PATIENTS AND MEASUREMENTS: Capillary lactate levels measured by a micromethod (CAPI) and arterial lactate levels measured by a standard laboratory method (ARTs) were simultaneously and repeatedly assayed in consecutive ICU patients with shock...
November 17, 2016: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/27862979/cerebral-tissue-oxygenation-index-and-lactate-at-24-hours-postoperative-predict-survival-and-neurodevelopmental-outcome-after-neonatal-cardiac-surgery
#4
Safwat A Aly, David Zurakowski, Penny Glass, Kami Skurow-Todd, Richard A Jonas, Mary T Donofrio
IMPORTANCE: There are no well-established noninvasive biomarkers for identifying patients at risk for poor outcome after surgery for congenital heart disease. Few studies have assessed prognostic accuracy of cerebral tissue oxygenation index (cTOI) measured by near infrared spectroscopy (NIRS). OBJECTIVE: To assess the utility of noninvasive NIRS monitoring as a predictor of outcomes after neonatal cardiac surgery through measurement of cTOI. To examine the utility of noninvasive NIRS monitoring in combination with lactate concentration and inotropic score in prediction of outcomes after neonatal cardiac surgery...
November 10, 2016: Congenital Heart Disease
https://www.readbyqxmd.com/read/27861824/lactation-support-services-and-breastfeeding-initiation-evidence-from-the-affordable-care-act
#5
Kandice A Kapinos, Lindsey Bullinger, Tami Gurley-Calvez
OBJECTIVE: Despite substantial evidence of the benefits of breastfeeding for both mothers and children, rates of sustained breastfeeding in the United States are quite low. This study examined whether mandated coverage of lactation support services under the Affordable Care Act (ACA) affects breastfeeding behavior. DATA SOURCE: We studied the census of U.S. births included in the National Vital Statistics System from 2009 to 2014. STUDY DESIGN: We used regression-adjusted difference-in-differences (DD) to examine changes in breastfeeding rates for privately insured mothers relative to those covered by Medicaid...
November 10, 2016: Health Services Research
https://www.readbyqxmd.com/read/27843178/the-handheld-blood-lactate-analyser-versus-the-blood-gas-based-analyser-for-measurement-of-serum-lactate-and-its-prognostic-significance-in-severe-sepsis
#6
Shivinder Singh, Abhishek Bhardawaj, Ratnesh Shukla, Trimbak Jhadav, Anoop Sharma, D Basannar
BACKGROUND: This study was done to compare the accuracy of the Lactate Pro LT 1710 (Arkray Inc., Kyoto, Japan) with the Combiline Plus (Eschweiler GmbH & Co. KG Holzkoppelweg, Kiel, Germany), and also, to analyze the prognostic significance of serum lactates and Simplified Acute Physiology Score 3 (SAPS 3) in patients of severe sepsis. METHODS: 106 patients of severe sepsis admitted to the ICU were screened. The serum lactate from an arterial sample analyzed in both the machines was recorded at admission and at 48 h...
October 2016: Medical Journal, Armed Forces India
https://www.readbyqxmd.com/read/27836621/analytical-performance-of-three-whole-blood-point-of-care-lactate-devices-compared-to-plasma-lactate-comparison-methods-and-a-flow-injection-mass-spectrometry-method
#7
Nicole V Tolan, Amy M Wockenfus, Christopher D Koch, Bridgit O Crews, Dennis J Dietzen, Brad S Karon
OBJECTIVES: Point of care (POC) whole blood lactate testing may facilitate rapid detection of sepsis. We evaluated three POC methods against both plasma lactate comparison methods and a flow-injection mass spectrometric (MS) method. DESIGN AND METHODS: Nova StatStrip, Abbott i-STAT CG4+ and Radiometer ABL90 POC lactate methods were evaluated against the mean of Cobas Integra 400 and Vitros 350 plasma lactate. POC methods were also compared to a flow-injection mass spectrometric assay measuring lactate in ZnSO4-precipitated whole blood extracts...
November 9, 2016: Clinical Biochemistry
https://www.readbyqxmd.com/read/27783141/emergency-abdominal-surgery-in-the-elderly-can-we-predict-mortality
#8
Anna E Sharrock, Jenny McLachlan, Robert Chambers, Ian S Bailey, James Kirkby-Bott
BACKGROUND: The United Kingdom population is ageing. Half of patients requiring an emergency laparotomy are aged over 70, 20 % die within 30 days, and less than half receive good care. Frailty and delay in management are associated with poor surgical outcomes. P-POSSUM risk scoring is widely accepted, but its validity in patients aged over 70 undergoing emergency laparotomy is unclear. AIMS: To assess if P-POSSUM risk stratification reliably predicts inpatient mortality in this group and establish whether those who died within 30 days received delayed care...
October 25, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27771592/breast-feeding-basic-competence-in-primary-care-development-and-validation-of-the-capa-questionnaire
#9
Anna Pol-Pons Rn Ibclc, Mercè Aubanell-Serra ScB, Mireia Vidal Rn, Imma Ojeda-Ciurana Rn, Ruth Martí-Lluch PhD, Anna Ponjoan PhD
BACKGROUND: validated and reliable tools measuring the level of competence about breastfeeding amongst health professionals who attend mothers in primary care are scarce. OBJECTIVE: to develop and validate a self-administered online questionnaire to assess basic competence about breastfeeding in the full range of health professionals attending lactating mothers in primary care. DESIGN: methodological study. SETTINGS: the study was conducted in 33 primary care centers administered by the Catalan Health Institute (Institut Català de la Salut) in the Girona Region (northeast Spain)...
October 1, 2016: Midwifery
https://www.readbyqxmd.com/read/27760242/lactation-in-the-human-breast-from-a-fluid-dynamics-point-of-view
#10
S Negin Mortazavi, Donna Geddes, Fatemeh Hassanipour
This study is a collaborative effort among lactation specialists and fluid dynamic engineers. The paper presents clinical results for suckling pressure pattern in lactating human breast as well as a 3D computational fluid dynamics (CFD) modeling of milk flow using these clinical inputs. The investigation starts with a careful, statistically representative measurement of suckling vacuum pressure, milk flow rate, and milk intake in a group of infants. The results from clinical data show that suckling action does not occur with constant suckling rate but changes in a rhythmic manner for infants...
January 1, 2017: Journal of Biomechanical Engineering
https://www.readbyqxmd.com/read/27740491/modeling-of-sam-impedance-onto-gold-and-silver-thin-film-mass-produced-electrodes-and-their-use-for-optimization-of-lactic-acid-detection
#11
Giulio Rosati, Matteo Scaramuzza, Elisabetta Pasqualotto, Alessandro De Toni, Carlo Reggiani, Alessandro Paccagnella
In this work, we demonstrate how an innovative, out-of-cleanroom customized CD/DVD fabrication process can be successfully used for mass production of biosensors with thin-film electrodes. We show that silver and gold electrodes can be used for impedimetric and voltammetric biosensing applications, both in presence and absence of a redox mediator. We modeled the redox/non-redox electrodes impedance through equivalent electrical circuits, and we evaluated their transfer function sensitivity with a one-factor-at-a-time approach...
October 10, 2016: IEEE Transactions on Nanobioscience
https://www.readbyqxmd.com/read/27648771/prehospital-point-of-care-lactate-following-trauma-a-systematic-review
#12
Christopher T Lewis, David N Naumann, Nick Crombie, Mark J Midwinter
BACKGROUND: Serum lactate serves as a surrogate marker for global tissue hypoxia following traumatic injury and has potential to guide resuscitation. Portable, handheld point-of-care monitoring devices enable lactate values to be readily available in the prehospital environment. The current review examines the utility of prehospital lactate (pLa) measurement in the management of trauma. METHODS: MEDLINE and EMBASE databases were searched using predefined criteria (pLa measurement, trauma patients) until March 10, 2016...
October 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27625735/prehospital-lactate-measurement-by-emergency-medical-services-in-patients-meeting-sepsis-criteria
#13
Lori L Boland, Jonathan S Hokanson, Karl M Fernstrom, Tyler G Kinzy, Charles J Lick, Paul A Satterlee, Brian K LaCroix
INTRODUCTION: We aimed to pilot test the delivery of sepsis education to emergency medical services (EMS) providers and the feasibility of equipping them with temporal artery thermometers (TATs) and handheld lactate meters to aid in the prehospital recognition of sepsis. METHODS: This study used a convenience sample of prehospital patients meeting established criteria for sepsis. Paramedics received education on systemic inflammatory response syndrome (SIRS) criteria, were trained in the use of TATs and hand-held lactate meters, and enrolled patients who had a recent history of infection, met ≥ 2 SIRS criteria, and were being transported to a participating hospital...
September 2016: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27625070/effects-of-exercise-on-alterations-in-redox-homeostasis-in-elite-male-and-female-endurance-athletes-using-a-clinical-point-of-care-test
#14
Nathan A Lewis, Colin Towey, Georgie Bruinvels, Glyn Howatson, Charles R Pedlar
Exercise causes alterations in redox homeostasis (ARH). Measuring ARH in elite athletes may aid in the identification of training tolerance, fatigued states, and underperformance. To the best of our knowledge, no studies have examined ARH in elite male and female distance runners at sea level. The monitoring of ARH in athletes is hindered by a lack of reliable and repeatable in-the-field testing tools and by the rapid turnaround of results. We examined the effects of various exercise intensities on ARH in healthy (non-over-reached) elite male and female endurance athletes using clinical point-of-care (POC) redox tests, referred to as the free oxygen radical test (FORT) (pro-oxidant) and the free oxygen radical defence (FORD) (antioxidant)...
October 2016: Applied Physiology, Nutrition, and Metabolism, Physiologie Appliquée, Nutrition et Métabolisme
https://www.readbyqxmd.com/read/27624355/impact-of-prosthesis-patient-mismatch-on-early-haemodynamic-status-after-aortic-valve-replacement
#15
Michel Kindo, Tam Hoang Minh, Stéphanie Perrier, Hélène Petit-Eisenmann, Jonathan Bentz, Mircea Cristinar, Gharib Ajob, Olivier Collange, Jean-Philippe Mazzucotelli
OBJECTIVES: Prosthesis-patient mismatch (PPM) has been reported to impact early haemodynamic status and early mortality after prosthetic aortic valve replacement (AVR) in patients with aortic stenosis (AS). The aim of this study was to assess the impact of PMM on early haemodynamic status after AVR using vasoactive-inotropic dependency index (VDI), postoperative pressures and end-organ perfusion. METHODS: A total of 183 patients with AS were included in this prospective cohort study, and underwent elective AVR with or without combined coronary artery bypass graft surgery...
September 13, 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/27547397/the-use-of-finger-stick-blood-to-assess-lactate-in-critically-ill-surgical-patients
#16
Joseph Sabat, Scott Gould, Ezra Gillego, Anita Hariprashad, Christine Wiest, Shailyn Almonte, David J Lucido, Asaf Gave, I Michael Leitman, Simon D Eiref
BACKGROUND: Using finger-stick capillary blood to assess lactate from the microcirculation may have utility in treating critically ill patients. Our goals were to determine how finger-stick capillary lactate correlates with arterial lactate levels in patients from the surgical intensive care unit, and to compare how capillary and arterial lactate trend over time in patients undergoing resuscitation for shock. METHODS: Capillary whole blood specimens were obtained from finger-sticks using a lancet, and assessed for lactate via a handheld point-of-care device as part of an "investigational use only" study...
September 2016: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/27546750/cost-effectiveness-analysis-of-early-point-of-care-lactate-testing-in-the-emergency-department
#17
Michael J Ward, Wesley H Self, Adam Singer, Danielle Lazar, Jesse M Pines
PURPOSE: To determine the cost-effectiveness of implementing a point-of-care (POC) Lactate Program in the emergency department (ED) for patients with suspected sepsis to identify patients who can benefit from early resuscitation. MATERIALS AND METHODS: We constructed a cost-effectiveness model to examine an ED with 30 000 patients annually. We evaluated a POC lactate program screening patients with suspected sepsis for an elevated lactate ≥4 mmol/L. Those with elevated lactate levels are resuscitated and their lactate clearance is evaluated by serial POC lactate measurements...
July 7, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27535746/serial-analysis-of-3d-h-1-mrsi-for-patients-with-newly-diagnosed-gbm-treated-with-combination-therapy-that-includes-bevacizumab
#18
Sarah J Nelson, Yan Li, Janine M Lupo, Marram Olson, Jason C Crane, Annette Molinaro, Ritu Roy, Jennifer Clarke, Nicholas Butowski, Michael Prados, Soonmee Cha, Susan M Chang
Interpretation of changes in the T1- and T2-weighted MR images from patients with newly diagnosed glioblastoma (GBM) treated with standard of care in conjunction with anti-angiogenic agents is complicated by pseudoprogression and pseudoresponse. The hypothesis being tested in this study was that 3D H-1 magnetic resonance spectroscopic imaging (MRSI) provides estimates of levels of choline, creatine, N-acetylaspartate (NAA), lactate and lipid that change in response to treatment and that metrics describing these characteristics are associated with survival...
October 2016: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/27503020/clinical-and-molecular-characteristics-in-100-chinese-pediatric-patients-with-m-3243a-g-mutation-in-mitochondrial-dna
#19
Chang-Yu Xia, Yu Liu, Hui Liu, Yan-Chun Zhang, Yi-Nan Ma, Yu Qi
BACKGROUND: Mitochondrial diseases are a group of energy metabolic disorders with multisystem involvements. Variable clinical features present a major challenge in pediatric diagnoses. We summarized the clinical spectrum of m.3243A>G mutation in Chinese pediatric patients, to define the common clinical manifestations and study the correlation between heteroplasmic degree of the mutation and clinical severity of the disease. METHODS: Clinical data of one-hundred pediatric patients with symptomatic mitochondrial disease harboring m...
August 20, 2016: Chinese Medical Journal
https://www.readbyqxmd.com/read/27451047/point-of-care-measurement-of-lactate
#20
REVIEW
Francesca Miranda Di Mauro, Gretchen Lee Schoeffler
Lactate is generated as a consequence of anaerobic glycolysis by all tissues of the body. Increased l-lactate, the isoform produced by most mammals, reflects increased anaerobic metabolism secondary to tissue hypoperfusion or tissue hypoxia in most clinical situations, and is called type A lactic acidosis. The utility of lactate measurement and serial lactate monitoring in veterinary patients has been demonstrated in multiple studies. Blood lactate concentration is significantly elevated in many disease processes including septic peritonitis, immune-mediated hemolytic anemia, Babesiosis, trauma, gastric dilation and volvulus, and intracranial disease...
March 2016: Topics in Companion Animal Medicine
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