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https://www.readbyqxmd.com/read/28821634/lipidomic-and-proteomic-analysis-of-exosomes-from-mouse-cortical-collecting-duct-cells
#1
Viet D Dang, Kishore Kumar Jella, Ragy R T Ragheb, Nancy D Denslow, Abdel A Alli
Exosomes are endosome-derived nanovesicles that are involved in cellular communication and signaling. Exosomes are produced by epithelial cells and are found in biologic fluids including blood and urine. The packaged material within exosomes includes proteins and lipids, but the molecular comparison within exosome subtypes is largely unknown. The purpose of this study was to investigate differences between exosomes derived from the apical plasma membrane and basolateral plasma membrane of polarized murine cortical collecting duct principal cells...
August 16, 2017: FASEB Journal: Official Publication of the Federation of American Societies for Experimental Biology
https://www.readbyqxmd.com/read/28820036/efficacy-and-safety-of-the-early-addition-of-vasopressin-to-norepinephrine-in-septic-shock
#2
Drayton A Hammond, Julia Cullen, Jacob T Painter, Kelsey McCain, Oktawia A Clem, Amy L Brotherton, Divyan Chopra, Nikhil Meena
BACKGROUND: Delays in achievement of target mean arterial pressure (MAP) have been associated with increased mortality in patients with septic shock. Vasopressin may be added to norepinephrine to raise MAP or decrease norepinephrine dosage. The purpose of this study was to determine whether early initiation of vasopressin to norepinephrine resulted in a reduced time to target MAP compared to norepinephrine monotherapy. METHODS: This retrospective cohort study compared early addition of vasopressin within 4 hours of septic shock onset to norepinephrine versus initial norepinephrine monotherapy in medically, critically ill patients with septic shock admitted from May 2014 to October 2015...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28816429/smart-cellulose-nanofluids-produced-by-tunable-hydrophobic-association-of-polymer-grafted-cellulose-nanocrystals
#3
Yea Ram Lee, Daehwan Park, Sang Koo Choi, Miju Kim, Heung Soo Baek, Jin Nam, Chan Bok Chung, Chinedum O Osuji, Jin Woong Kim
Cellulose fibrils, unique plant-derived semi-crystalline nanomaterials with exceptional mechanical properties, have significant potential for rheology modification of complex fluids due to their ability to form a physically associated semi-flexible fibrillary network. Here, we report new associative cellulose nanocrystals (ACNCs) with stress-responsive rheological behaviors in an aqueous solution. The surface-mediated living radical polymerization was employed to graft poly (stearyl methacrylate-co-2-methacryloxyethyl phosphorylcholine) brushes onto the nanofibrils, and then 2,2,6,6-tetramethylpiperidine-1-oxyl radical (TEMPO)-mediated oxidation was conducted to produce nanoscale ACNCs in the aqueous solution...
August 17, 2017: ACS Applied Materials & Interfaces
https://www.readbyqxmd.com/read/28814248/pediatric-abdominal-trauma
#4
Tim Lynch
Abdominal trauma is present in approximately 25% of pediatric patients with major trauma and is the most common cause of unrecognized fatal injury in children. Pediatric abdominal trauma is typically blunt in nature with the spleen being the most common organ injured. Non-operative management is employed in over 95% of patients. Penetrating injuries are less common but often require operative management. Knowledge of specific mechanisms of injury aids the clinician in the diagnosis of specific injuries. Computed tomography (CT) is the gold standard in the identification of intra-abdominal injury...
August 14, 2017: Current Pediatric Reviews
https://www.readbyqxmd.com/read/28814247/fluid-and-medication-considerations-in-the-traumatized-patient
#5
Amita Misir
This article reviews fluid therapy and medications in pediatric trauma. For resuscitation in the setting of hemorrhagic shock, isotonic crystalloid solution is the first-line agent of choice. Colloid solutions offer no additional benefit, introduce possible increased risks and cost more than crystalloids. Blood products, starting with pRBCs, should be introduced after 20-40 ml/kg of crystalloid has been administered if there is ongoing need for volume replacement. The use of a massive transfusion protocol of 1:1:1 (if >30 kg) or 30:20:20 (if <30 kg) of pRBCs:FFP:platelets is suggested after an initial 30 ml/kg of pRBcs have been administered...
August 14, 2017: Current Pediatric Reviews
https://www.readbyqxmd.com/read/28812000/diagnostic-imaging-features-of-necrotizing-enterocolitis-a-narrative-review
#6
REVIEW
Francesco Esposito, Rosanna Mamone, Marco Di Serafino, Carmela Mercogliano, Valerio Vitale, Gianfranco Vallone, Patrizia Oresta
Necrotizing enterocolitis (NEC) is an inflammatory process, characterized by intestinal necrosis of variable extension, leading to perforation, generalized peritonitis and death. The classical pathogenetic theory focuses on mucosal damage related to a stress induced intestinal ischemia leading to mucosal injury and bacterial colonization of the wall. A more recent hypothesis emphasizes the role of immaturity of gastrointestinal and immune system, particularly of the premature, responsible of bowel wall vulnerability and suffering...
June 2017: Quantitative Imaging in Medicine and Surgery
https://www.readbyqxmd.com/read/28809612/a-retrospective-study-evaluating-the-efficacy-of-identification-and-management-of-sepsis-at-a-district-level-hospital-internal-medicine-department-in-the-western-cape-province-south-africa-in-comparison-with-the-guidelines-stipulated-in-the-2012-survivi
#7
Raisa Bhikoo, Sarah Versfeld, M M De V Basson, Almero H Oosthuizen
BACKGROUND: Currently there is little information on the identification, management and outcomes of patients with sepsis in developing countries. Simple cost-effective measures such as accurate identification of patients with sepsis and early antibiotic administration are achievable targets, within reach without having to make use of unsustainable protocols constructed in developed countries. OBJECTIVES: To assess the ability of clinicians at a district-level hospital to identify and manage sepsis, and to assess patient outcome in terms of in-hospital mortality and length of hospital stay given the above management...
July 28, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28807037/selepressin-a-novel-selective-vasopressin-v1a-agonist-is-an-effective-substitute-for-norepinephrine-in-a-phase-iia-randomized-placebo-controlled-trial-in-septic-shock-patients
#8
James A Russell, Jean-Louis Vincent, Anne Louise Kjølbye, Håkan Olsson, Allan Blemings, Herbert Spapen, Peder Carl, Pierre-Francois Laterre, Lars Grundemar
BACKGROUND: Vasopressin is widely used for vasopressor support in septic shock patients, but experimental evidence suggests that selective V1A agonists are superior. The initial pharmacodynamic effects, pharmacokinetics, and safety of selepressin, a novel V1A-selective vasopressin analogue, was examined in a phase IIa trial in septic shock patients. METHODS: This was a randomized, double-blind, placebo-controlled multicenter trial in 53 patients in early septic shock (aged ≥18 years, fluid resuscitation, requiring vasopressor support) who received selepressin 1...
August 15, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28800865/contemporary-reviews-in-critical-care-medicine-anaphylaxis
#9
REVIEW
Daniel LoVerde, Onyinye I Iweala, Ariana Eginli, Guha Krishnaswamy
Anaphylaxis is a systemic, life threatening disorder triggered by mediators released by mast cells and basophils activated via allergic (IgE-mediated) or non-allergic (non-IgE-mediated) mechanisms. It is a rapidly evolving, multisystem process involving the integumentary, pulmonary, gastrointestinal and cardiovascular systems. Anaphylaxis and angioedema are serious disorders that can lead to fatal airway obstruction and culminate in cardiorespiratory arrest resulting in hypoxemia and/or shock. Often, these disorders can be appropriately managed in an outpatient setting...
August 8, 2017: Chest
https://www.readbyqxmd.com/read/28795671/-two-dimensional-speckle-tracking-imaging-in-assessing-the-left-ventricular-systolic-function-and-its-dynamic-changes-of-patients-with-septic-shock
#10
Fei Yang, Yong Chen, Ruiqiang Zheng, Yong Ma, Haidi Yu, Wenjuan Zhang, Yang Zhang
OBJECTIVE: To evaluate early and dynamic changes of the left ventricular systolic function of patients with septic shock by two-dimensional speckle tracking imaging (2D-STI), and to provide guidance for treatment and prognosis. METHODS: Fifty-eight septic shock patients admitted to intensive care unit (ICU) of Subei People's Hospital from January 2016 to April 2017 were enrolled. The septic shock patients were given early fluid resuscitation. The left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), left ventricular ejection fraction (LVEF), early diastolic mitral flow velocity/early diastolic mitral annular peak velocity (E/Em) were obtained by conventional echocardiography, and the left ventricular global longitudinal strain (GLS), global circumferential strain (GCS), global radial strain (GRS) were obtained by 2D-STI before fluid resuscitation and 1, 3, 7, 14 days after fluid resuscitation...
August 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28795240/biocontractile-microfluidic-channels-for-peristaltic-pumping
#11
Angelina V Shutko, Vasily S Gorbunov, Konstantin G Guria, Konstantin I Agladze
Bio-actuated micro-pumps do not need any external power source and pose no risk of electrical or heat shock for the biological materials in lab-on-chip systems. Several different designs of bio-actuated micro-pumps based on the use of the contractile force of cultured cardiomyocites have been proposed earlier. Here we present a novel type of a bio-actuated micro-pump representing a microfluidic channel with a contractile wall. The flow inside the channel is generated by the peristaltic movement of its wall caused by the propagation of an excitation-contraction wave along the channels surface...
August 9, 2017: Biomedical Microdevices
https://www.readbyqxmd.com/read/28794474/porosity-evolution-at-the-brittle-ductile-transition-in-the-continental-crust-implications-for-deep-hydro-geothermal-circulation
#12
M Violay, M J Heap, M Acosta, C Madonna
Recently, projects have been proposed to engineer deep geothermal reservoirs in the ductile crust. To examine their feasibility, we performed high-temperature (up to 1000 °C), high-pressure (130 MPa) triaxial experiments on granite (initially-intact and shock-cooled samples) in which we measured the evolution of porosity during deformation. Mechanical data and post-mortem microstuctural characterisation (X-ray computed tomography and scanning electron microscopy) indicate that (1) the failure mode was brittle up to 900 °C (shear fracture formation) but ductile at 1000 °C (no strain localisation); (2) only deformation up to 800 °C was dilatant; (3) deformation at 900 °C was brittle but associated with net compaction due to an increase in the efficiency of crystal plastic processes; (4) ductile deformation at 1000 °C was compactant; (5) thermally-shocking the granite did not influence strength or failure mode...
August 9, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28789803/preliminary-performance-on-the-new-cms-sepsis-1-national-quality-measure-early-insights-from-the-emergency-quality-network-e-qual
#13
Arjun K Venkatesh, Todd Slesinger, Jessica Whittle, Tiffany Osborn, Emily Aaronson, Craig Rothenberg, Nalani Tarrant, Pawan Goyal, Donald M Yealy, Jeremiah D Schuur
STUDY OBJECTIVE: We describe current hospital-level performance for the Centers for Medicare & Medicaid Services' Severe Sepsis/Septic Shock Early Management Bundle (SEP-1) quality measure and qualitatively assess emergency department (ED) sepsis quality improvement best practice implementation. METHODS: Using a standardized Web-based submission portal, we surveyed quality improvement data from volunteer hospital-based EDs participating in the Emergency Quality Network Sepsis Initiative...
August 5, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28777197/elabela-improves-cardio-renal-outcome-in-fatal-experimental-septic-shock
#14
David Coquerel, Frédéric Chagnon, Xavier Sainsily, Lauralyne Dumont, Alexandre Murza, Jérôme Côté, Robert Dumaine, Philippe Sarret, Éric Marsault, Dany Salvail, Mannix Auger-Messier, Olivier Lesur
OBJECTIVES: Apelin-13 was recently proposed as an alternative to the recommended β-adrenergic drugs for supporting endotoxin-induced myocardial dysfunction. Since Apelin-13 signals through its receptor (Apelin peptide jejunum) to exert singular inotropic/vasotropic actions and to optimize body fluid balance, this candidate pathway might benefit septic shock management. Whether the newly discovered ELABELA (ELA), a second endogenous ligand of the Apelin peptide jejunum receptor highly expressed in the kidney, further improves cardio-renal impairment remains unknown...
August 2, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28777139/fluid-bolus-over-15-20-versus-5-10-minutes-each-in-the-first-hour-of-resuscitation-in-children-with-septic-shock-a-randomized-controlled-trial
#15
Jhuma Sankar, Javed Ismail, M Jeeva Sankar, Suresh C P, Rameshwar S Meena
OBJECTIVES: To compare the effect of administration of 40-60 mL/kg of fluids as fluid boluses in aliquots of 20 mL/kg each over 15-20 minutes with that over 5-10 minutes each on the composite outcome of need for mechanical ventilation and/or impaired oxygenation-increase in oxygenation index by 5 from baseline in the initial 6 and 24 hours in children with septic shock. DESIGN: Randomized controlled trial. SETTING: Pediatric emergency and ICU of a tertiary care institute...
August 2, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28774323/understanding-fluid-administration-approaches-in-children-with-co-morbidities-and-septic-shock
#16
EDITORIAL
Niranjan Kissoon
No abstract text is available yet for this article.
August 2, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28763904/-discussion-on-the-related-problems-of-pediatric-burn-treatment
#17
Z Y Li, Z Lyu
The incidence of pediatric burn is high currently. Many clinical problems in the treatment of pediatric burn are composed of fluid replacement during shock stage, wound treatment, nutrition and metabolism etc, which urgently need to be sorted out and updated again to make corresponding clinical guidelines, criteria, or consensus for standardizing the clinical diagnosis and treatment, so as to improve the clinical treatment level of pediatric burn.
July 20, 2017: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
https://www.readbyqxmd.com/read/28762448/comparison-of-warm-fluid-and-cold-fluid-resuscitation-during-uncontrolled-hemorrhagic-shock-model-in-rats
#18
Serkan Dilmen, Mehmet Eryılmaz, Salih Müjdat Balkan, Muhittin Serdar, Murat Durusu, Ali Osman Yıldırım, Sanem Aslıhan Dilmen
BACKGROUND: This study was designed to compare the effects of resuscitation with cold and warm fluid on survival time, rate and volume of hemorrhage, hemodynamics, hypothermia, coagulopathy, acid-base balance, hematocrit, lactate, and base deficit during uncontrolled hemorrhagic shock (HS) model in rats. METHODS: HS model was created with splenic vascular and parenchymal injury in 29 rats under ketamine and xylazine anesthesia. Thirty minutes after the hemorrhage, the rats were randomized to receive 14...
July 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28758605/rescue-extracorporeal-membrane-oxygenation-therapy-in-methamphetamine-toxicity
#19
Laura K Morrison, J Kromm, J Gaudet, D Zuege, B Button, F Warshawski, S N Lucyk
Complications related to methamphetamine use and abuse are common presentations seen in the emergency department. Standard management focuses on addressing the central nervous system and cardiovascular effects with the use of sedation and hemodynamic support. We describe a case report of a patient with methamphetamine toxicity and subsequent severe cardiomyopathy refractory to conventional management that responded to cardiovascular support with extracorporeal membrane oxygenation therapy (ECMO). A 22-year-old female was admitted in severe cardiogenic shock following intravenous administration of methamphetamine and oral fentanyl use...
July 31, 2017: CJEM
https://www.readbyqxmd.com/read/28756901/respiratory-variation-in-femoral-vein-diameter-has-moderate-accuracy-as-a-marker-of-fluid-responsivity-in-mechanically-ventilated-septic-shock-patients
#20
Wagner Luis Nedel, Daniele Moraes Simas, Luiz Gustavo Marin, Vinicius Daudt Morais, Gilberto Friedman
Ultrasound (US) is considered the first step in evaluation of patients with shock; respiratory variation of the inferior vena cava (inferior vena cava collapsibility [IVCc]) is an important measurement in this scenario that can be impaired by patient condition or technical skills. The main objective of this study was to evaluate if respiratory variation of the femoral vein (femoral vein collapsibility [FVc]), which is easier to visualize, can adequately predict fluid responsiveness in septic shock patients...
July 27, 2017: Ultrasound in Medicine & Biology
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