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https://www.readbyqxmd.com/read/29229195/a-comparison-of-two-different-fluid-resuscitation-management-protocols-for-pediatric-burn-patients-a-retrospective-study
#1
Miao Huang, Jun-Feng Chen, Li-Ying Chen, Li-Qin Pan, Xiao-Jian Li, Jie-Yu Ye, Hui-Yi Tan
OBJECTIVE: Pediatric burn patients are more susceptible to burn shock than adults, and an effective fluid management protocol is critical to successful resuscitation. Our research aim was to investigate the safety and efficacy of two protocols for pediatric burn patients for use within the first 24h. METHODS: A total of 113 pediatric burn patients were enrolled from January 2007 to October 2012. Of those patients, 57 received fluid titration regimens of alternating crystalloids and colloids once within 2h in the first 24h after burn (Group A), whereas the remaining patients received regimens of alternating crystalloids and colloids once within 1h in the first 24h after burn (Group B)...
December 8, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/29221616/dengue-fever-report-from-the-task-force-on-tropical-diseases-by-the-world-federation-of-societies-of-intensive-and-critical-care-medicine
#2
REVIEW
Pravin Amin, Özlem Acicbe, Jorge Hidalgo, Juan Ignacio Silesky Jiménez, Tim Baker, Guy A Richards
Dengue is an arbovirus affecting humans and spread by mosquitoes. Severe dengue follows a secondary infection with a different virus serotype. The problem is truly global as it is endemic in over 100 countries. Severe dengue can be a life-threatening because of increased vascular permeability, resulting in leakage of fluid from the intravascular compartment to the extravascular space. When major bleeding does occur, it is almost invariably combined with profound shock since this, in combination with thrombocytopenia, hypoxia, and acidosis, can lead to multiple organ failure and disseminated intravascular coagulation...
November 5, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29219435/chemical-enhancements-in-shock-accelerated-particles-ab%C3%A2-initio-simulations
#3
Damiano Caprioli, Dennis T Yi, Anatoly Spitkovsky
We study the thermalization, injection, and acceleration of ions with different mass/charge ratios, A/Z, in nonrelativistic collisionless shocks via hybrid (kinetic ions-fluid electrons) simulations. In general, ions thermalize to a postshock temperature proportional to A. When diffusive shock acceleration is efficient, ions develop a nonthermal tail whose extent scales with Z and whose normalization is enhanced as (A/Z)^{2} so that incompletely ionized heavy ions are preferentially accelerated. We discuss how these findings can explain observed heavy-ion enhancements in Galactic cosmic rays...
October 27, 2017: Physical Review Letters
https://www.readbyqxmd.com/read/29216937/-significance-of-peripheral-perfusion-index-in-early-diagnosis-and-goal-directed-therapy-of-septic-shock-patients-a-prospective-single-blind-randomized-controlled-trial
#4
Yuanfeng Shi, Ruihong Yin, Yanli Wang, Jiguang Li, Xiaobing Chen, Yongpeng Xie, Caihong Gu, Xiuzhen Zou, Kexi Liu
OBJECTIVE: To investigate the application of peripheral perfusion index (PPI) in early diagnosis and goal-directed therapy of septic shock, and to provide reference for the early clinical diagnosis and treatment of septic shock. METHODS: A prospective single-blind randomized controlled trial (RCT) was conducted. Adult patients with sepsis admitted to emergency medical department and intensive care unit (ICU) of the First People's Hospital of Lianyungang City in Jiangsu Province from January 2013 to December 2016 were enrolled...
December 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29210983/the-potential-pathogenic-contributions-of-endothelial-barrier-and-arterial-contractile-dysfunction-to-shock-due-to-b-anthracis-lethal-and-edema-toxins
#5
REVIEW
Dante A Suffredini, Xizhong Cui, Wanying Xu, Yan Li, Peter Q Eichacker
Shock with B. anthracis infection is particularly resistant to conventional cardiovascular support and its mortality rate appears higher than with more common bacterial pathogens. As opposed to many bacteria that lack exotoxins directly depressing hemodynamic function, lethal and edema toxin (LT and ET respectively) both cause shock and likely contribute to the high lethality rate with B. anthracis. Selective inhibition of the toxins is protective in infection models, and administration of either toxin alone in animals produces hypotension with accompanying organ injury and lethality...
December 6, 2017: Toxins
https://www.readbyqxmd.com/read/29205142/necrotizing-fasciitis-associated-with-primary-cutaneous-b-cell-lymphoma-a-case-report
#6
K G Spiridakis, D S Intzepogazoglou, M E Flamourakis, E E Sfakianakis, A V Daskalaki, E K Vakonaki, E Rahmanis, G E Kostakis, M S Christodoulakis
Necrotizing fasciitis is a rapidly progressive and life-threatening infection of the deeper skin layers and subcutaneous tissues that moves along the facial planes. OBJECTIVES: We present the rare case of a patient with necrotizing fasciitis associated with high malignancy b-cell lymphoma. Our purpose is to investigate the probable connection between the two pathologies and evaluate the importance of early surgical intervention. CASE REPORT: 51-year old Caucasian woman presented at the E...
May 2017: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/29204871/bone-marrow-mesenchymal-stem-cells-combat-lipopolysaccharide-induced-sepsis-in-rats-via-amendment-of-p38-mapk-signaling-cascade
#7
Omnia S Zaki, Marwa M Safar, Afaf A Ain-Shoka, Laila A Rashed
Sepsis is a systemic inflammatory disorder which often occurs during extremely stressful conditions such as trauma, burn, shock, and infection. This study investigated the curative effects of bone marrow-derived mesenchymal stem cells (BM-MSCs) against hepatic, renal, and pulmonary responses caused by a single administration of lipopolysaccharide (LPS) (10 mg/kg, i.p) in rats. Treatment with BM-MSCs (5 × 105 in 0.1 ml PBS, i.p.) 3 h after LPS antagonized the LPS-induced increment of the liver enzymes (ALT, AST) and kidney functions (BUN, sCr)...
December 4, 2017: Inflammation
https://www.readbyqxmd.com/read/29203716/immune-tolerance-therapies-for-autoimmune-diseases-based-on-heat-shock-protein-t-cell-epitopes
#8
REVIEW
Willem van Eden
Experimental models of autoimmune diseases have revealed the disease protective role of heat shock proteins (HSPs). Both the administration of exogenous extracellular, mostly recombinant, HSP and the experimental co-induction of endogenous intracellular HSP in models have been shown to lead to production of disease protective regulatory T cells (Tregs). Similar to HSP taken up from extracellular bodily fluids, due to stress-related autophagy upregulated HSP also from intracellular sources is a major provider for the major histocompatibility class II (MHCII) ligandome; therefore, both extracellular and intracellular HSP can be prominent targets of Treg...
January 19, 2018: Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences
https://www.readbyqxmd.com/read/29203707/extracellular-cell-stress-heat-shock-proteins-immune-responses-and-disease-an-overview
#9
REVIEW
A Graham Pockley, Brian Henderson
Extracellular cell stress proteins are highly conserved phylogenetically and have been shown to act as powerful signalling agonists and receptors for selected ligands in several different settings. They also act as immunostimulatory 'danger signals' for the innate and adaptive immune systems. Other studies have shown that cell stress proteins and the induction of immune reactivity to self-cell stress proteins can attenuate disease processes. Some proteins (e.g. Hsp60, Hsp70, gp96) exhibit both inflammatory and anti-inflammatory properties, depending on the context in which they encounter responding immune cells...
January 19, 2018: Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences
https://www.readbyqxmd.com/read/29201914/acute-right-ventricular-dysfunction-in-intensive-care-unit
#10
REVIEW
Juan C Grignola, Enric Domingo
The role of the left ventricle in ICU patients with circulatory shock has long been considered. However, acute right ventricle (RV) dysfunction causes and aggravates many common critical diseases (acute respiratory distress syndrome, pulmonary embolism, acute myocardial infarction, and postoperative cardiac surgery). Several supportive therapies, including mechanical ventilation and fluid management, can make RV dysfunction worse, potentially exacerbating shock. We briefly review the epidemiology, pathophysiology, diagnosis, and recommendations to guide management of acute RV dysfunction in ICU patients...
2017: BioMed Research International
https://www.readbyqxmd.com/read/29201066/anaphylactic-shock-following-castor-bean-contact-a-case-report
#11
Y Coattrenec, D Jaques, P Jandus, T Harr, D Spoerl
Background: The castor bean plant, Ricinus communis, is known to have allergenic and toxic properties. Castor bean allergy has been described mainly as an occupational inhalation allergy in laboratory workers, in persons working in oil processing mills or in agricultural industry. So far, only one case of anaphylactic reaction due to castor bean sensitization confirmed by specific IgE has been described in literature. Case presentation: A 30-year-old woman presented to the emergency room with severe angioedema followed by urticaria, hypotension and tachycardia...
2017: Allergy, Asthma, and Clinical Immunology
https://www.readbyqxmd.com/read/29197350/effect-of-hyperchloremia-on-acute-kidney-injury-in-critically-ill-septic-patients-a-retrospective-cohort-study
#12
Lenar Yessayan, Javier A Neyra, Fabrizio Canepa-Escaro, George Vasquez-Rios, Michael Heung, Jerry Yee
BACKGROUND: Hyperchloremia is common in critically ill septic patients. The impact of hyperchloremia on the incidence of acute kidney injury (AKI) is not well studied. We investigated the association between hyperchloremia and AKI within the first 72 h of intensive care unit (ICU) admission. METHODS: 6490 ICU adult patients admitted with severe sepsis or septic shock were screened for eligibility. Exclusion criteria included: AKI on admission, baseline estimated glomerular filtration rate (eGFR) <15 ml/min/1...
December 2, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/29195914/early-fluid-loading-for-septic-patients-any-safety-limit-needed
#13
REVIEW
Yi-Chun Gong, Jing-Tao Liu, Peng-Lin Ma
Early adequate fluid loading was the corner stone of hemodynamic optimization for sepsis and septic shock. Meanwhile, recent recommended protocol for fluid resuscitation was increasingly debated on hemodynamic stability vs risk of overloading. In recent publications, it was found that a priority was often given to hemodynamic stability rather than organ function alternation in the early fluid resuscitation of sepsis. However, no safety limits were used at all in most of these reports. In this article, the rationality and safety of early aggressive fluid loading for septic patients were discussed...
November 8, 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/29192359/a-field-and-laboratory-study-of-the-responses-of-cytoprotection-and-osmoregulation-to-salinity-stress-in-mosquitofish-gambusia-affinis
#14
Jeng-Wei Tsai, Hon-Jung Liew, Jyun-Jiang Jhang, Shiou-Han Hung, Pei-Jie Meng, Ming-Yih Leu, Christopher Lim, Cheng-Hao Tang
The mosquitofish (Gambusia affinis) naturally inhabits freshwater (FW; 1-3‰) and seawater (SW; 28-33‰) ponds in constructed wetland. To explore the physiological status and molecular mechanisms for salinity adaptation of the mosquitofish, cytoprotective responses and osmoregulation were examined. In the field study, activation of protein quality control (PQC) mechanism through upregulation of the abundance of heat shock protein (HSP) 90 and 70 and ubiquitin-conjugated proteins was found in the mosquitofish gills from SW pond compared to the individuals of FW pond...
December 1, 2017: Fish Physiology and Biochemistry
https://www.readbyqxmd.com/read/29189297/are-on-scene-blood-transfusions-by-a-helicopter-emergency-medical-service-useful-and-safe-a-multicentre-case-control-study
#15
Joost H Peters, Pascal S H Smulders, Xavier R J Moors, Stef J M Bouman, Claartje M E M Meijs, Nico Hoogerwerf, Michael J R Edwards
INTRODUCTION: In the prehospital setting, crystalloid fluids are frequently used, but only erythrocytes are capable of transporting oxygen to tissues. The aim of this study was to establish the efficacy and safety of the prehospital use of uncross matched type O rhesus-negative packed red blood cells (URBC) by the Dutch physician-staffed helicopter emergency medical service. We hypothesized that prehospital URBC transfusions are safe and more effective with respect to survival than resuscitations with crystalloids...
November 17, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/29179059/determination-of-recombinant-interferon-%C3%AE-2-in-e-coli-periplasmic-extracts-by-reversed-phase-high-performance-liquid-chromatography
#16
Paulo V S Dias, Fernanda S Arthuso, João E Oliveira, Miriam F Suzuki, José M Sousa, Maria Teresa C P Ribela, Paolo Bartolini, Carlos R J Soares
Reversed-phase high-performance liquid chromatography (RP-HPLC) has been used to analyze Interferon α-2 (IFN-α2) as a pure protein or as a pharmaceutical preparation: a method for analyzing periplasmic IFN-α2 directly in osmotic shock extract has, however, never been reported. This work describes an RP-HPLC methodology for the qualitative and quantitative analysis of human IFN-α2a and IFN-α2b directly in bacterial periplasmic extracts or in purified preparations. The analytical method has been set up and validated for accuracy, precision, linearity, sensitivity and specificity...
November 21, 2017: Journal of Chromatography. B, Analytical Technologies in the Biomedical and Life Sciences
https://www.readbyqxmd.com/read/29176794/capillary-refill-time-during-fluid-resuscitation-in-patients-with-sepsis-related-hyperlactatemia-at-the-emergency-department-is-related-to-mortality
#17
Barbara Lara, Luis Enberg, Marcos Ortega, Paula Leon, Cristobal Kripper, Pablo Aguilera, Eduardo Kattan, Ricardo Castro, Jan Bakker, Glenn Hernandez
INTRODUCTION: Acute circulatory dysfunction in patients with sepsis can evolve rapidly into a progressive stage associated with high mortality. Early recognition and adequate resuscitation could improve outcome. However, since the spectrum of clinical presentation is quite variable, signs of hypoperfusion are frequently unrecognized in patients just admitted to the emergency department (ED). Hyperlactatemia is considered a key parameter to disclose tissue hypoxia but it is not universally available and getting timely results can be challenging in low resource settings...
2017: PloS One
https://www.readbyqxmd.com/read/29176402/clinical-outcomes-of-minimized-hydrocortisone-dosage-of-100%C3%A2-mg-day-on-lower-occurrence-of-hyperglycemia-in-septic-shock-patients
#18
Kanchana Ngaosuwan, Kanit Ounchokdee, Thep Chalermchai
BACKGROUND: The current international guideline recommended 200 mg per day of hydrocortisone intravenously to treat septic shock. However, a subsequent study on cortisol metabolism actually showed an increase in cortisol level during sepsis. Hence, the smaller hydrocortisone dose of 100 mg per day might be sufficient and reduce steroid-associated complications. We aimed to compare the clinical outcomes of minimized hydrocortisone dose of 100 mg to the currently recommended dose in the treatment of septic shock patients...
November 15, 2017: Shock
https://www.readbyqxmd.com/read/29176401/2017-military-supplement-dodecafluoropentane-emulsion-ddfpe-as-a-resuscitation-fluid-for-treatment-of-hemorrhagic-shock-and-traumatic-brain-injury-a-review
#19
Kaitlin Graham, Paula F Moon-Massat, Evan C Unger
Dodecafluoropentane emulsion (DDFPe) is a novel nanotechnology for oxygen delivery with therapeutic potential for hemorrhagic shock and/or traumatic brain injury (TBI). DDFPe demonstrates efficacy at smaller doses than previously tested perfluorocarbon oxygen therapeutics. This smaller dose potentially eliminates toxicities exhibited by previous oxygen therapeutics, while anti-inflammatory properties of DDFPe may alleviate damage from ischemia reperfusion injury. This mini-review summarizes our progress in developing a battle-field ready product to prevent combat death due to hemorrhagic shock and/or TBI...
November 15, 2017: Shock
https://www.readbyqxmd.com/read/29175047/hemorrhagic-shock-drives-glycocalyx-barrier-and-organ-dysfunction-early-after-polytrauma
#20
Rebecca Halbgebauer, Christian K Braun, Stephanie Denk, Benjamin Mayer, Paolo Cinelli, Peter Radermacher, Guido A Wanner, Hans-Peter Simmen, Florian Gebhard, Daniel Rittirsch, Markus Huber-Lang
Polytrauma (PT) is frequently associated with hemorrhagic shock (HS), which increases morbidity and mortality. Although various aspects of HS have been addressed in PT patients, the impact of an additional HS is largely unknown regarding the development of multiple organ dysfunction associated with disturbed glycocalyx and barrier function early after trauma. A prospective, longitudinal, mono-centered, observational study enrolling severely injured patients (Injury Severity Score, ISS=38.1±2.6) served for an in-depth analysis of blood (drawn on days 0, 1, 2, 3 and 5) and clinical data (up to 21days) of 30 patients who were then stratified into PT with and without HS...
November 16, 2017: Journal of Critical Care
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