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https://www.readbyqxmd.com/read/29222827/responding-to-parental-requests-for-life-sustaining-treatment%C3%A2-relational-potential-revisited
#1
Aaron Wightman, Jennifer Cobelli Kett, Benjamin Wilfond
One of the most challenging situations for pediatric clinicians is responding to parental requests for life-sustaining medical therapies for a child with profound neurodevelopmental disabilities. These therapies (e.g. intravenous medications and fluids, gastrostomy tube feeds, dialysis, tracheostomy, and/or mechanical ventilation) offer the possibility for the child to live, at home or in a facility, for months or years as opposed to experiencing their imminent death. While relatively rare, the tension surrounding these requests can be exceptionally high, as illustrated by the cases of Baby K, Baby Joseph, Jahi McMath, Charlie Gard, and many others from our own experience...
December 8, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/29221272/goal-directed-fluid-restriction-using-stroke-volume-variation-and-cardiac-index-during-one-lung-ventilation-a-randomized-controlled-trial
#2
Hui Xu, Shu-Hua Shu, Di Wang, Xiao-Qing Chai, Yan-Hu Xie, Wei-De Zhou
Background: Goal-directed therapy confers a strong prognosis in patients undergoing major cardiac or noncardiac surgery. The present study investigated whether intraoperative goal-directed fluid restriction (GDFR) using stroke volume variation (SVV) and cardiac index could improve oxygenation and postoperative outcome in patients undergoing one-lung ventilation (OLV). Methods: A Total of 168 patients scheduled for elective thoracoscopic lobectomy under OLV were randomized into the GDFR protocol (group G) or conventional fluid therapy groups (group C)...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29218857/the-combined-effect-of-thermal-and-chemotherapy-on-hela-cells-using-magnetically-actuated-smart-textured-fibrous-system
#3
Pranav Tiwari, Sakshi Agarwal, Sachchidanand Srivastava, Shilpee Jain
Thermal therapy combined with chemotherapy is one of the advanced and efficient methods to eradicate cancer. In this work, we fabricated magnetically actuated smart textured (MAST) fibrous systems and studied their candidacy for cancer treatment. The polycaprolactone-Fe3 O4 based MAST fibers were fabricated using electrospinning technique. These MAST fibrous systems contained carbogenic quantum dots as a tracking agent and doxorubicin hydrochloride anticancer drug. Additionally, as fabricated MAST fibrous systems were able to deliver anticancer drug and heat energy simultaneously to kill HeLa cells in a 10 min period in vitro...
January 2018: Journal of Biomedical Materials Research. Part B, Applied Biomaterials
https://www.readbyqxmd.com/read/29217890/nontubercular-mycobacterial-infection-in-a-renal-allograft-recipient
#4
U Anandh, K Jayanna
A 71-year-old male, a renal allograft recipient, presented to us with a history of fever and right palm swelling. He had a history of fever 7 years back when he was treated with antitubercular treatment (ATT). Three years back, he was diagnosed to have gout and he was started on allopurinol. He developed severe bone marrow toxicity and allopurinol was changed to febuxostat. On admission, routine investigations did not reveal any focus of infection. The fluid aspirate from the palm revealed acid-fast bacilli (AFB)...
November 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/29217612/mycobacterium-tuberculosis-of-the-elbow-joint
#5
Quintin Liao, James George Shepherd, Sulman Hasnie
Mycobacterium tuberculosis(TB) affecting the elbow joint is rarely reported in the developed world. We present the case of an 85-year-old Caucasian female who complained of a chronically discharging and painful wound across her left elbow during her admission for an ischaemic stroke. This was initially deemed to be either a bursitis or local manifestation of amyloid by her general practitioner and dermatologist respectively prior to admission. She was commenced on flucloxacillin by the medical team for presumed cellulitis with minimal response...
December 6, 2017: BMJ Case Reports
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
#6
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/29216644/prognostic-factors-and-efficacy-for-continuous-renal-replacement-therapy-in-critically-ill-patients-a-chinese-single-center-retrospective-study
#7
Jing Zhang, Yiming Li, Zhiyong Peng
BACKGROUND: There is controversy about the efficacy and prognostic factors for continuous renal replacement therapy (CRRT) in China due to practice variation. Our aim is to investigate these questions. METHOD: A total of 613 adult patients receiving CRRT in last 3 years from one Chinese ICU were enrolled. The analysis of demographic data, vital signs, and laboratory tests prior to CRRT and outcomes were performed. The data between pre- and post-CRRT were compared for efficacy analysis...
December 7, 2017: Blood Purification
https://www.readbyqxmd.com/read/29216198/hcv-kinetic-and-modeling-analyses-project-shorter-durations-to-cure-under-combined-therapy-with-daclatasvir-and-asunaprevir-in-chronic-hcv-infected-patients
#8
Laetitia Canini, Michio Imamura, Yoshiiku Kawakami, Susan L Uprichard, Scott J Cotler, Harel Dahari, Kazuaki Chayama
BACKGROUND & AIMS: High cure rates are achieved in HCV genotype-1b patients treated with daclatasvir and asunaprevir, DCV/ASV. Here we analyzed early HCV kinetics in genotype-1b infected Japanese subjects treated with DCV/ASV and retrospectively projected, using mathematical modeling, whether shorter treatment durations might be effective. METHODS: HCV RNA levels were measured frequently during DCV/ASV therapy in 95 consecutively treated patients at a single center in Japan...
2017: PloS One
https://www.readbyqxmd.com/read/29215110/quercetin-inhibits-renal-cyst-growth-in-vitro-and-via-parenteral-injection-in-a-polycystic-kidney-disease-mouse-model
#9
Yangyang Zhu, Tian Teng, Hu Wang, Hao Guo, Lei Du, Baoxue Yang, Xiaoxing Yin, Ying Sun
Autosomal dominant polycystic kidney disease (ADPKD) is a common monogenic disease characterized by massive enlargement of fluid-filled cysts in the kidney. There is an urgent need to develop effective ADPKD therapies. We used an in vitro Madin-Darby canine kidney (MDCK) cyst model and a murine embryonic kidney cyst model to evaluate whether quercetin inhibits cyst development. We then used a polycystic kidney disease (PKD) mouse model to further determine the in vivo effects of quercetin (100 mg per kg body weight twice per day) on PKD mice via subcutaneous injections...
December 7, 2017: Food & Function
https://www.readbyqxmd.com/read/29210488/acute-polyneuromyopathy-with-respiratory-failure-secondary-to-monensin-intoxication-in-a-dog
#10
Luis Bosch, Alexa M Bersenas, Shane Bateman
OBJECTIVE: To describe a successfully managed case of polyneuropathy and respiratory failure secondary to presumed monensin intoxication. CASE SUMMARY: A 9-month-old Australian Shepherd was evaluated for progressive generalized weakness and respiratory distress. Several days preceding presentation, the dog was seen playing with a monensin capsule, and had free access to a barn where the product was stored and where chewed capsules were subsequently found. The dog was presented with flaccid tetraparesis, hyperthermia, and severe respiratory distress...
December 6, 2017: Journal of Veterinary Emergency and Critical Care
https://www.readbyqxmd.com/read/29210355/neuroangiostrongyliasis-the-subarachnoid-phase-and-its-implications-for-anthelminthic-therapy
#11
Paul Prociv, Megan Turner
Infection with the Rat Lungworm Angiostrongylus cantonensis is the leading cause of human eosinophilic meningoencephalitis worldwide. From its origins in southeastern Asia, the parasite was spread extensively throughout the twentieth century and is now established in many of the world's warmer regions. Its clinical effects range from mild and transient symptoms, usually headache with peripheral nerve dysfunction, to severe and permanent central nervous system (CNS) damage, occasionally fatal. The severity and prognosis of disease are determined by the larval dose, acquired by ingesting infected intermediate hosts (slugs and snails) or, less often, paratenic hosts, such as crabs, shrimps, frogs, and monitor lizards...
December 4, 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/29208752/effects-of-alanyl-glutamine-treatment-on-the-peritoneal-dialysis-effluent-proteome-reveal-pathomechanism-associated-molecular-signatures
#12
Rebecca Herzog, Michael Boehm, Markus Unterwurzacher, Anja Wagner, Katja Parapatics, Peter Majek, André C Mueller, Anton Lichtenauer, Keiryn L Bennett, Seth L Alper, Andreas Vychytil, Christoph Aufricht, Klaus Kratochwill
Peritoneal dialysis (PD) is a modality of renal replacement therapy in which the high volumes of available PD effluent (PDE) represents a rich source of biomarkers for monitoring disease and therapy. Although this information could help guide the management of PD patients, little is known about the potential of PDE to define pathomechanism-associated molecular signatures in PD.</p> <p>We therefore subjected PDE to a high-performance multiplex proteomic analysis after depletion of highly-abundant plasma proteins and enrichment of low-abundance proteins...
December 4, 2017: Molecular & Cellular Proteomics: MCP
https://www.readbyqxmd.com/read/29208260/ghrelin-ameliorates-asthma-by-inhibiting-endoplasmic-reticulum-stress
#13
Tian Fu, Lei Wang, Qingdi Zeng, Yan Zhang, Baowei Sheng, Liping Han
BACKGROUND: This study aimed to confirm the ameliorative effect of ghrelin on asthma and investigate its mechanism. MATERIALS AND METHODS: The murine model of asthma was induced by ovalbumin (OVA) treatment and assessed by histological pathology and airway responsiveness to methacholine. The total and differential leukocytes were counted. Tumor necrosis factor α, interferon γ, interleukin-5 and interleukin-13 levels in bronchoalveolar lavage fluid were quantified by commercial kits...
December 2017: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/29208198/-idiopathic-oedema
#14
Christina Courtnadge, Flemming Madsen, Anette Bygum
Idiopathic oedema is a non-inflammatory interstitial oedema seen in fertile women. A hallmark is a daily increase in weight > 1.4 kg from morning until evening due to fluid retention, which shows as facial puffiness in the morning and more often abdominal increase and swollen lower extremities during the day. Patients may be disabled due to accompanying symptoms like headache, dizziness, fatigue, anxiety, and depression. The diagnosis is based on clinical features and exclusion of other causes of oedema...
November 27, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/29207027/galectin-3-as-a-novel-biomarker-for-disease-diagnosis-and-a-target-for-therapy-review
#15
Rui Dong, Min Zhang, Qunying Hu, Shan Zheng, Andrew Soh, Yijie Zheng, Hui Yuan
Galectin-3 is a member of the galectin family, which are β‑galactoside‑binding lectins with ≥1 evolutionary conserved carbohydrate‑recognition domain. It binds proteins in a carbohydrate‑dependent and ‑independent manner. Galectin‑3 is predominantly located in the cytoplasm; however, it shuttles into the nucleus and is secreted onto the cell surface and into biological fluids including serum and urine. It serves important functions in numerous biological activities including cell growth, apoptosis, pre‑mRNA splicing, differentiation, transformation, angiogenesis, inflammation, fibrosis and host defense...
December 5, 2017: International Journal of Molecular Medicine
https://www.readbyqxmd.com/read/29206736/fluid-overload-and-extracorporeal-membrane-oxygenation-is-renal-replacement-therapy-a-buoy-or-an-anchor
#16
Rashid Alobaidi, Laurance Lequier
No abstract text is available yet for this article.
December 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29206727/assessment-of-myocardial-function-and-injury-by-echocardiography-and-cardiac-biomarkers-in-african-children-with-severe-plasmodium-falciparum-malaria
#17
Simon Kotlyar, Peter Olupot-Olupot, Julius Nteziyaremye, Samuel O Akech, Sophie Uyoga, Rita Muhindo, Christopher L Moore, Kathryn Maitland
OBJECTIVES: Perturbed hemodynamic function complicates severe malaria. The Fluid Expansion as Supportive Therapy trial demonstrated that fluid resuscitation, involving children with severe malaria, was associated with increased mortality, primarily due to cardiovascular collapse, suggesting that myocardial dysfunction may have a role. The aim of this study was to characterize cardiac function in children with severe malaria. DESIGN: A prospective observational study with clinical, laboratory, and echocardiographic data collected at presentation (T0) and 24 hours (T1) in children with severe malaria...
December 4, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29204838/volumetric-response-of-progressing-post-srs-lesions-treated-with-laser-interstitial-thermal-therapy
#18
Vivek B Beechar, Sujit S Prabhu, Dhiego Bastos, Jeffrey S Weinberg, R Jason Stafford, David Fuentes, Kenneth R Hess, Ganesh Rao
We analyzed volumetric response of metastatic brain tumors that progressed despite treatment with stereotactic radiosurgery (SRS) after treatment with laser interstitial thermal therapy (LITT). We retrospectively reviewed consecutive patients treated from 1/2012 to 10/2015 with LITT for metastatic brain tumors demonstrating progression after SRS. Volumes were quantified using MRI with contrast-enhanced T1-weighted (T1W) and fluid-attenuated inversion recovery (FLAIR). Fifty lesions from 36 patients were studied...
December 4, 2017: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/29204652/effect-of-nasal-continuous-positive-airway-pressure-on-infants-with-meconium-aspiration-syndrome-a-randomized-clinical-trial
#19
Aakash Pandita, Srinivas Murki, Tejo Pratap Oleti, Baswaraj Tandur, Sai Kiran, Sachin Narkhede, Amrut Prajapati
Importance: Nasal continuous positive airway pressure (NCPAP) as a primary respiratory therapy in meconium aspiration syndrome (MAS) has not been studied extensively. Nasal continuous positive airway pressure, when applied in newborns with MAS, may resolve atelectasis by sufficiently expanding partially obstructed small airways and stabilizing the collapsing terminal airways to enhance oxygen exchange. Objective: To compare NCPAP vs standard care in neonates with moderate to severe respiratory failure due to MAS in reducing the need for invasive ventilation...
December 4, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/29204189/reversible-splenial-lesion-syndrome-resles-coinciding-with-cerebral-venous-thrombosis-a-report-of-two-cases
#20
REVIEW
Jingyi Liu, Dacheng Liu, Bo Yang, Jing Yan, Yuehua Pu, Jing Zhang, Miao Wen, Zhonghua Yang, Liping Liu
A total of two postpartum women with no noteworthy medical history presented with persistent headache. Brain magnetic resonance imaging (MRI) of both revealed extensive cerebral venous thrombosis, concurrently with abnormal signals of the splenium of the corpus callosum (SCC): The splenium appeared hyperintense on T2-weighted sequences, fluid-attenuated inversion recovery (FLAIR), and diffusion-weighted imaging (DWI) imaging, and hypointense on T1 sequences and apparent diffusion coefficient (ADC) map. The patients were given thrombolytic therapy...
December 2017: Therapeutic Advances in Neurological Disorders
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