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https://www.readbyqxmd.com/read/28528537/intraoperative-mechanical-ventilation-state-of-the-art
#1
Lorenzo Ball, Federico Costantino, Giulia Orefice, Karthikka Chandrapatham, Paolo Pelosi
Mechanical ventilation is a cornerstone of the intraoperative management of the surgical patient and is still mandatory in several surgical procedures. In the last decades, research focused on preventing postoperative pulmonary complications (PPCs), both improving risk stratification through the use of predictive scores and protecting the lung adopting so-called protective ventilation strategies. The aim of this review is to give an up-to-date overview of the currently suggested intraoperative ventilation strategies, along with their pathophysiologic rationale, with a focus on challenging conditions, such as obesity, one-lung ventilation and cardiopulmonary bypass...
May 19, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28528324/new-role-for-interleukin-13-receptor-%C3%AE-1-in-myocardial-homeostasis-and-heart-failure
#2
Uri Amit, David Kain, Allon Wagner, Avinash Sahu, Yael Nevo-Caspi, Nir Gonen, Natali Molotski, Tal Konfino, Natalie Landa, Nili Naftali-Shani, Galia Blum, Emmanuelle Merquiol, Danielle Karo-Atar, Yariv Kanfi, Gidi Paret, Ariel Munitz, Haim Y Cohen, Eytan Ruppin, Sridhar Hannenhalli, Jonathan Leor
BACKGROUND: The immune system plays a pivotal role in myocardial homeostasis and response to injury. Interleukins-4 and -13 are anti-inflammatory type-2 cytokines, signaling via the common interleukin-13 receptor α1 chain and the type-2 interleukin-4 receptor. The role of interleukin-13 receptor α1 in the heart is unknown. METHODS AND RESULTS: We analyzed myocardial samples from human donors (n=136) and patients with end-stage heart failure (n=177). We found that the interleukin-13 receptor α1 is present in the myocardium and, together with the complementary type-2 interleukin-4 receptor chain Il4ra, is significantly downregulated in the hearts of patients with heart failure...
May 20, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28527261/-posterior-reversible-encephalopathy-syndrome-report-of-a-fatal-case-and-analysis-of-predictive-factors-of-a-poor-prognosis
#3
Moisés Ulises Torres, Ligia Victoria Delgado, Natalia Giraldo, Piedad Urueña, Sergio Franco, Olga Helena Hernández
Posterior reversible encephalopathy syndrome is an illness with multiple causes and distinctive clinicalradiological characteristics that should be known by intensivists and emergency room physicians for a timely diagnosis and treatment. A fatal case of posterior reversible encephalopathy syndrome is presented, and the risk factors related to the outcome are identified.A 60-year-old man without a relevant medical history arrived at the emergency room presenting with depressed consciousness, seizures, and high blood pressure...
April 1, 2017: Biomédica: Revista del Instituto Nacional de Salud
https://www.readbyqxmd.com/read/28527191/understanding-how-a-sport-helmet-protects-the-head-from-closed-injury-by-virtual-impact%C3%A2-tests
#4
Yunhua Luo, Zhaoyang Liang
Understanding how a helmet protects the head, especially the soft brain tissues, is the prerequisite for improving helmet design. Intracranial pressure and stresses/strains in the brain tissues are the direct indicators of traumatic brain injury and they can be used to measure helmet performance. In this study, the effects of helmet design parameters such as the helmet shell stiffness, liner compliance and thickness on the brain injury indicators were investigated by virtual impact tests. A finite element head model (FEHM) was first constructed from medical images; a personally-fitted helmet made of composite material and foam was virtually prototyped using geometric information extracted from the FEHM; a helmet-head finite element model was then assembled...
2017: Bio-medical Materials and Engineering
https://www.readbyqxmd.com/read/28525977/the-intracerebral-hemorrhage-acutely-decreasing-arterial-pressure-trial-ii-ich-adapt-ii-protocol
#5
Laura Gioia, Ana Klahr, Mahesh Kate, Brian Buck, Dariush Dowlatshahi, Thomas Jeerakathil, Derek Emery, Kenneth Butcher
BACKGROUND: Aggressively lowering blood pressure (BP) in acute intracerebral hemorrhage (ICH) may improve outcome. Although there is no evidence that BP reduction changes cerebral blood flow, retrospective magnetic resonance imaging (MRI) studies have demonstrated sub-acute ischemic lesions in ICH patients. The primary aim of this study is to assess ischemic lesion development in patients randomized to two different BP treatment strategies. We hypothesize aggressive BP reduction is not associated with ischemic injury after ICH...
May 19, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28525856/oleuropein-prevents-the-development-of-experimental-autoimmune-myocarditis-in-rats
#6
Jia-Ying Zhang, Zheng Yang, Kun Fang, Zhan-Li Shi, Dan-Hong Ren, Jing Sun
Oleuropein (OLE) is a natural secoiridoid that is derived from Olea europaea. OLE possesses cardioprotective effects in experimental models of hypertension, myocardial infarction, atherosclerosis and hyperlipidaemia. In the present study, the effects of OLE on experimental autoimmune myocarditis (EAM) were evaluated. EAM in rats were induced by subcutaneous injections of porcine cardiac myosin. Cardiac function parameters, myocardial pathology, myocardial inflammatory cell infiltration and nuclear factor kappa-B (NF-κB) expression were measured...
May 16, 2017: International Immunopharmacology
https://www.readbyqxmd.com/read/28525682/secondary-sulcus-fixed-foldable-iol-implantation-with-25-g-infusion-in-patients-with-previous-ppv-after-open-globe-injury
#7
Tiangeng He, Caiyun You, Song Chen, Xiangda Meng, Yuanyuan Liu, Hua Yan
PURPOSE: To evaluate the safety and efficacy of secondary sulcus-fixed foldable intraocular lens (IOL) implantation through a clear corneal incision with 25-G infusion in patients with previous pars plana vitrectomy (PPV) after open-globe injury, and to analyze postoperative outcomes and prognostic factors of treatment. METHODS: Clinical data of 89 eyes of 89 patients with open-globe injury who underwent secondary sulcus-fixed foldable IOL implantation through a clear corneal incision with 25-G infusion after vitrectomy in our hospital between January 2008 and June 2015 were retrospectively analyzed...
May 16, 2017: European Journal of Ophthalmology
https://www.readbyqxmd.com/read/28524074/neurotrauma-the-crosstalk-between-neurotrophins-and-inflammation-in-the-acutely-injured-brain
#8
REVIEW
Lindolfo da Silva Meirelles, Daniel Simon, Andrea Regner
Traumatic brain injury (TBI) is a major cause of morbidity and mortality among young individuals worldwide. Understanding the pathophysiology of neurotrauma is crucial for the development of more effective therapeutic strategies. After the trauma occurs, immediate neurologic damage is produced by the traumatic forces; this primary injury triggers a secondary wave of biochemical cascades together with metabolic and cellular changes, called secondary neural injury. In the scenario of the acutely injured brain, the ongoing secondary injury results in ischemia and edema culminating in an uncontrollable increase in intracranial pressure...
May 18, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28523456/bone-marrow-mesenchymal-stem-cell-administration-significantly-improves-outcome-after-retinal-ischemia-in-rats
#9
Biji Mathew, Jacqueline N Poston, John C Dreixler, Leianne Torres, Jasmine Lopez, Ruth Zelkha, Irina Balyasnikova, Maciej S Lesniak, Steven Roth
PURPOSE: Ischemia-associated retinal degeneration is one of the leading causes of vision loss, and to date, there are no effective treatment options. We hypothesized that delayed injection of bone-marrow stem cells (BMSCs) 24 h after the onset of ischemia could effectively rescue ischemic retina from its consequences, including apoptosis, inflammation, and increased vascular permeability, thereby preventing retinal cell loss. METHODS: Retinal ischemia was induced in adult Wistar rats by increasing intraocular pressure (IOP) to 130-135 mmHg for 55 min...
May 18, 2017: Graefe's Archive for Clinical and Experimental Ophthalmology
https://www.readbyqxmd.com/read/28523127/high-intensity-focused-ultrasound-hifu-ablation-of-benign-thyroid-nodules-a-systematic-review
#10
REVIEW
Brian Hung-Hin Lang, Arnold L H Wu
BACKGROUND: With an increasing number of imaging studies being done nowadays, the number of incidentally discovered thyroid nodules is expected to rise. Although many of these nodules are small and benign in nature, some do grow and may cause pressure and/or thyrotoxic symptoms. Surgical resection has traditionally been recommended for symptomatic nodules but is associated with risk of hypothyroidism, bleeding, infection, and nerve damage. High intensity focused ultrasound (HIFU) is one of the non-surgical thermal ablation techniques that may serve as an alternative in the treatment of benign thyroid nodules...
2017: Journal of Therapeutic Ultrasound
https://www.readbyqxmd.com/read/28522914/one-year-experience-with-computer-assisted-propofol-sedation-for-colonoscopy
#11
Otto S Lin, Danielle La Selva, Richard A Kozarek, Deborah Tombs, Wade Weigel, Ryan Beecher, Johannes Koch, Susan McCormick, Michael Chiorean, Fred Drennan, Michael Gluck, Nanda Venu, Michael Larsen, Andrew Ross
AIM: To report our one-year experience with computer assisted propofol sedation (CAPS) for colonoscopy as the first United States Medical Center to adopt CAPS technology for routine clinical use. METHODS: Between September 2014 and August 2015, 2677 patients underwent elective outpatient colonoscopy with CAPS at our center. All colonoscopies were performed by 1 of 17 gastroenterologists certified in the use of the CAPS system, with the assistance of a specially trained nurse...
April 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28522833/parkin-regulation-of-chop-modulates-susceptibility-to-cardiac-endoplasmic-reticulum-stress
#12
Kim Han, Shahin Hassanzadeh, Komudi Singh, Sara Menazza, Tiffany T Nguyen, Mark V Stevens, An Nguyen, Hong San, Stasia A Anderson, Yongshun Lin, Jizhong Zou, Elizabeth Murphy, Michael N Sack
The regulatory control of cardiac endoplasmic reticulum (ER) stress is incompletely characterized. As ER stress signaling upregulates the E3-ubiquitin ligase Parkin, we investigated the role of Parkin in cardiac ER stress. Parkin knockout mice exposed to aortic constriction-induced cardiac pressure-overload or in response to systemic tunicamycin (TM) developed adverse ventricular remodeling with excessive levels of the ER regulatory C/EBP homologous protein CHOP. CHOP was identified as a Parkin substrate and its turnover was Parkin-dose and proteasome-dependent...
May 18, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28522763/aortic-arch-compliance-and-idiopathic-unilateral-vocal-fold-paralysis
#13
Reza Behkam, Kara E Roberts, Andrew J Bierhals, M Eileen Jacobs, Julia D Edgar, Randal C Paniello, Gayle Woodson, Jonathan P Vande Geest, Julie M Barkmeier-Kraemer
Unilateral vocal fold paralysis (UVP) occurs related to recurrent laryngeal nerve (RLN) impairment associated with impaired swallowing, voice production, and breathing functions. The majority of UVP cases occur subsequent to surgical intervention with approximately 12-42% having no known cause for the disease (i.e., idiopathic). Approximately 2/3 of those with UVP exhibit left-sided injury with the average onset at 50 years of age or older in those diagnosed as idiopathic. Given the association between the RLN and the subclavian and aortic arch vessels, we hypothesized that changes in vascular tissues would result in increased aortic compliance in idiopathic left-sided UVP patients compared to those without UVP...
May 18, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28522676/midlife-and-late-life-vascular-risk-factors-and-white-matter-microstructural-integrity-the-atherosclerosis-risk-in-communities-neurocognitive-study
#14
Melinda C Power, Jonathan V Tingle, Robert I Reid, Juebin Huang, A Richey Sharrett, Josef Coresh, Michael Griswold, Kejal Kantarci, Clifford R Jack, David Knopman, Rebecca F Gottesman, Thomas H Mosley
BACKGROUND: Diffusion tensor imaging measures of white matter (WM) microstructural integrity appear to provide earlier indication of WM injury than WM hyperintensities; however, risk factors for poor WM microstructural integrity have not been established. Our study quantifies the association between vascular risk factors in midlife and late life with measures of late-life WM microstructural integrity. METHODS AND RESULTS: We used data from 1851 participants in ARIC (Atherosclerosis Risk in Communities Study) who completed 3-T magnetic resonance imaging, including diffusion tensor imaging, as part of the ARIC Neurocognitive Study (ARIC-NCS)...
May 18, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28521863/high-pre-ischemic-fatty-acid-levels-decrease-cardiac-recovery-in-an-isolated-rat-heart-model-of-donation-after-circulatory-death
#15
Petra Niederberger, Emilie Farine, Maria Arnold, Rahel K Wyss, Maria N Sanz, Natalia Méndez-Carmona, Brigitta Gahl, Georg M Fiedler, Thierry P Carrel, Hendrik T Tevaearai Stahel, Sarah L Longnus
RATIONALE: Donation after circulatory death (DCD) could improve cardiac graft availability. However, strategies to optimize cardiac graft recovery remain to be established in DCD; these hearts would be expected to be exposed to high levels of circulatory fat immediately prior to the inevitable period of ischemia prior to procurement. OBJECTIVE: We investigated whether acute exposure to high fat prior to warm, global ischemia affects subsequent hemodynamic and metabolic recovery in an isolated rat heart model of DCD...
June 2017: Metabolism: Clinical and Experimental
https://www.readbyqxmd.com/read/28520763/genome-wide-gene-expression-array-identifies-novel-genes-related-to-disease-severity-and-excessive-daytime-sleepiness-in-patients-with-obstructive-sleep-apnea
#16
Yung-Che Chen, Kuang-Den Chen, Mao-Chang Su, Chien-Hung Chin, Chung-Jen Chen, Chia-Wei Liou, Ting-Wen Chen, Ya-Chun Chang, Kuo-Tung Huang, Chin-Chou Wang, Ting-Ya Wang, Jen-Chieh Chang, Yong-Yong Lin, Yi-Xin Zheng, Meng-Chih Lin, Chang-Chun Hsiao
We aimed to identify novel molecular associations between chronic intermittent hypoxia with re-oxygenation and adverse consequences in obstructive sleep apnea (OSA). We analyzed gene expression profiles of peripheral blood mononuclear cells from 48 patients with sleep-disordered breathing stratified into four groups: primary snoring (PS), moderate to severe OSA (MSO), very severe OSA (VSO), and very severe OSA patients on long-term continuous positive airway pressure treatment (VSOC). Comparisons of the microarray gene expression data identified eight genes up-regulated with OSA and down-regulated with CPAP treatment, and five genes down-regulated with OSA and up-regulated with CPAP treatment...
2017: PloS One
https://www.readbyqxmd.com/read/28520545/hemodynamic-profile-of-acute-kidney-injury-following-the-fontan-procedure-impact-of-renal-perfusion-pressure
#17
Taylor Patterson, David A Hehir, Matthew Buelow, Pippa M Simpson, Michael E Mitchell, Liyun Zhang, Mehdi Eslami, Kathleen Murkowski, John P Scott
BACKGROUND: Acute kidney injury (AKI) is common following cardiopulmonary bypass. Fontan completion may result in systemic venous hypertension and low cardiac output, reducing renal perfusion pressure (RPP) and further increasing the risk of AKI. We investigated the incidence and risk factors for post-Fontan AKI. METHODS: Single-center retrospective study of children undergoing Fontan completion from 2005 to 2012. Demographic and hemodynamic variables were assessed for association with AKI...
May 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28515948/cerebral-air-embolism-associated-with-penetrating-lung-injury-a-case-report-and-review-of-the-literature
#18
Ayumu Yamaoka, Kei Miyata, Eichi Narimatsu, Eiji Sakawaki, Sonoko Sakawaki, Suguru Hirayama, Shuji Uemura, Naoya Yama
CASE: A 44-year-old man intentionally stabbed himself in the anterior neck and left thorax with a fruit knife. Physical examination revealed two open wounds entering the thoracic cavity in the front chest, and a stab wound entering the trachea at the neck. Two chest tubes were initially inserted for the left lung injury with open hemopneumothorax. Nevertheless, the worsening oxygenation required positive pressure ventilation (PPV) with endotracheal intubation. OUTCOME: Right hemiparesis was found during weaning from PPV...
April 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/28515606/gender-based-assessment-of-survival-in-trauma-hemorrhagic-shock-a-retrospective-analysis-of-indian-population
#19
Pankaj Verma, Sanjeev Bhoi, Upendra Baitha, Tej Prakash Sinha, Prakash Ranjan Mishra
INTRODUCTION: Trauma-hemorrhagic shock (THS) is a leading cause of death. Female rats and women experience better outcomes in terms of survival after major trauma as compared to males. There are limited data in Indian population. Authors studied the gender-based outcome of patients with Class IV hemorrhagic shock due to blunt trauma and the distribution of factors among males and females which are known to affect outcome. MATERIALS AND METHODS: It was a retrospective study with data of trauma victims between January 2008 and July 2013...
April 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28515518/is-segmental-epidural-anaesthesia-an-optimal-technique-for-patients-undergoing-percutaneous-nephrolithotomy
#20
Devangi A Parikh, Geeta A Patkar, Mayur S Ganvir, Ajit Sawant, Bharati A Tendolkar
BACKGROUND AND AIMS: Neuraxial anaesthesia has recently become popular for percutaneous nephrolithotomy (PCNL). We conducted a study comparing general anaesthesia (GA) with segmental (T6-T12) epidural anaesthesia (SEA) for PCNL with respect to anaesthesia and surgical characteristics. METHODS: Ninety American Society of Anesthesiologists Physical Status-I and II patients undergoing PCNL randomly received either GA or SEA. Overall patient satisfaction was the primary end point...
April 2017: Indian Journal of Anaesthesia
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