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https://www.readbyqxmd.com/read/29756066/postanaesthetic-shivering-from-pathophysiology-to-prevention
#1
REVIEW
Maria Bermudez Lopez
Postoperative shivering is a common complication of anaesthesia. Shivering is believed to increase oxygen consumption, increase the risk of hypoxemia, induce lactic acidosis, and catecholamine release. Therefore, it might increase the postoperative complications especially in high-risk patients. Moreover, shivering is one of the leading causes of discomfort for postsurgical patients. Shivering is usually triggered by hypothermia. However, it occurs even in normothermic patients during the perioperative period...
April 2018: Romanian Journal of Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29737362/-regional-citrate-anticoagulation-in-renal-replacement-therapy-in-the-intensive-care-station-recommendations-from-the-renal-section-of-the-dgiin-%C3%A3-giain-and-divi
#2
REVIEW
M Schmitz, M Joannidis, D Czock, S John, A Jörres, S J Klein, M Oppert, V Schwenger, J Kielstein, A Zarbock, D Kindgen-Milles, C Willam
BACKGROUND: Regional citrate anticoagulation (RCA) in continuous renal replacement therapy can effectively anticoagulate dialysis circuits without having adverse effects on systemic heparin application. In particular, in continuous renal replacement therapy RCA is well established and represents a safe procedure with longer filter lifetimes and fewer bleeding complications. OBJECTIVES: To provide guidance on the indications, advantages and disadvantages, and use of RCA, current recommendations from the renal section of the DGIIN (Deutschen Gesellschaft für Internistische Intensivmedizin und Notfallmedizin), ÖGIAIN (Österreichischen Gesellschaft für Internistische und Allgemeine Intensivmedizin und Notfallmedizin) and DIVI (Deutschen Interdisziplinären Vereinigung für Intensiv- und Notfallmedizin) are stated...
May 8, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/29701196/-research-progress-in-renal-injury-relevant-to-primary-sj%C3%A3-gren-s-syndrome
#3
Yao Zou, Guanghui Ling, Jing Tian, Jinwei Chen, Yan Ge
Primary Sjögren's syndrome (pSS) is a chronic autoimmune disease characterized by lymphoplasmacytic infiltration of the exocrine glands that results in multiple organs and systems damage. Renal injury affects 0.3%-27.0% patients. The most frequent form of nephropathy in pSS is tubulointerstitial nephritis. The main clinical manifestation is renal tubular acidosis. The renal prognosis in patients with pSS is usually favorable, but renal failure may occur. At present, it still lacks of strict consensus or guideline for the treatment...
March 28, 2018: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
https://www.readbyqxmd.com/read/29621906/fhr-patterns-that-become-significant-in-connection-with-st-waveform-changes-and-metabolic-acidosis-at-birth
#4
Karl G Rosén, Håkan Norén, Ann Carlsson
INTRODUCTION: Recent developments have produced new CTG classification systems and the question is to what extent these may affect the model of FHR + ST interpretation? The two new systems (FIGO2015 and SSOG2017) classify FHR+ ST events differently from the current CTG classification system used in the STAN interpretation algorithm (STAN2007). AIM: Identify the predominant FHR patterns in connection with ST events in cases of cord artery metabolic acidosis missed by the different CTG classification systems...
April 5, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29563012/diabetes-in-childhood-and-adolescence
#5
Ralph Ziegler, Andreas Neu
BACKGROUND: The incidence of type 1 diabetes mellitus in childhood and adolescence is steadily rising and now stands at 22.9 new cases per year per 100 000 persons up to age 15. METHODS: This review is based on pertinent publications retrieved by a selective literature search, with special attention to the current German S3 guideline on diabetes in childhood and adolescence. RESULTS: Polydipsia, polyuria, and weight loss are the characteristic presenting symptoms of diabetes mellitus...
March 2, 2018: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/29495132/acid-base-assessment-of-patients-receiving-hemodialysis-what-are-our-management-goals
#6
F John Gennari
Acid-base assessment of patients receiving conventional hemodialysis (HD) has been based solely on predialysis serum [total CO2 ], and treatment is currently driven by the KDOQI guideline from 2000. This guideline was directed solely at minimizing metabolic acidosis and thereby improving bone and muscle metabolism. In 2000, no data were available to assess the effects of acid-base status on morbidity and mortality. Since then, new data have emerged from several large cohort studies about the association between variations in predialysis serum [total CO2 ], as well as blood pH, and morbidity and mortality risk...
March 1, 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29455774/metformin-in-heart-failure-patients
#7
REVIEW
Abdulhalim Jamal Kinsara, Yasser Mansour Ismail
The use of metformin was considered a contraindication in heart failure patients because of the potential risk of lactic acidosis; however, more recent evidence has shown that this should no longer be the case. We reviewed the current literature and the recent guideline to correct the misconception.
January 2018: Indian Heart Journal
https://www.readbyqxmd.com/read/29431385/glucose-management-in-hospitalized-patients
#8
Charles Kodner, Laurie Anderson, Katherine Pohlgeers
Glucose management in hospitalized patients poses challenges to physicians, including identifying blood glucose targets, judicious use of oral diabetes mellitus medications, and implementing appropriate insulin regimens. Uncontrolled blood glucose levels can lead to deleterious effects on wound healing, increased risk of infection, and delays in surgical procedures or discharge from the hospital. Previously recommended strict blood glucose targets for hospitalized patients result in more cases of hypoglycemia without improvement in patient outcomes...
November 15, 2017: American Family Physician
https://www.readbyqxmd.com/read/29381982/metabolic-acidosis-of-chronic-kidney-disease-and-subclinical-cardiovascular-disease-markers-friend-or-foe
#9
Cristina Căpuşă, Gabriel Ştefan, Simona Stancu, Mariana Lipan, Lilach Daniel Tsur, Gabriel Mircescu
The effect of chronic metabolic acidosis (MA) on cardiovascular disease (CVD) in the setting of chronic kidney disease (CKD) is largely unknown. Therefore, we aimed to study this relationship in nondialysis CKD patients.This cross-sectional, single-center study prospectively enrolled 95 clinically stable CKD patients (median age 61 (58, 65) years, 60% male, median eGFR 27 (22, 32) mL/min). Data on CKD etiology, CVD history, CVD traditional, and nontraditional risk factors were obtained. Also, markers of subclinical CVD were assessed: intima-media thickness (IMT), abdominal aortic calcifications (Kauppila score-AACs), cardio-ankle vascular index (CAVI), ankle-brachial index (ABI), ejection fraction, and interventricular septum thickness...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29370874/international-practices-in-the-dietary-management-of-fructose-1-6-biphosphatase-deficiency
#10
A Pinto, M Alfadhel, R Akroyd, Y Atik Altınok, S M Bernabei, L Bernstein, G Bruni, G Caine, E Cameron, R Carruthers, B Cochrane, A Daly, F de Boer, S Delaunay, A Dianin, M Dixon, E Drogari, S Dubois, S Evans, J Gribben, G Gugelmo, C Heidenborg, I Hunjan, I L Kok, B Kumru, A Liguori, D Mayr, E Megdad, U Meyer, R B Oliveira, A Pal, A Pozzoli, R Pretese, J C Rocha, S Rosenbaum-Fabian, J Serrano-Nieto, E Sjoqvist, C Timmer, L White, T van den Hurk, M van Rijn, H Zweers, M Ziadlou, A MacDonald
BACKGROUND: In fructose 1,6 bisphosphatase (FBPase) deficiency, management aims to prevent hypoglycaemia and lactic acidosis by avoiding prolonged fasting, particularly during febrile illness. Although the need for an emergency regimen to avoid metabolic decompensation is well established at times of illness, there is uncertainty about the need for other dietary management strategies such as sucrose or fructose restriction. We assessed international differences in the dietary management of FBPase deficiency...
January 25, 2018: Orphanet Journal of Rare Diseases
https://www.readbyqxmd.com/read/29359487/review-article-long-term-safety-of-oral-anti-viral-treatment-for-chronic-hepatitis-b
#11
REVIEW
G L-H Wong, W-K Seto, V W-S Wong, M-F Yuen, H L-Y Chan
BACKGROUND: Safety profile of nucleos(t)ide analogues is an important issue in view of its widespread use for decades in patients with chronic hepatitis B (CHB). AIM: To review and evaluate the latest evidence on the safety profiles of the six approved nucleoside analogues. METHODS: Relevant articles related to nucleoside analogue safety were selected for review following extensive language- and date-unrestricted, electronic searches of the literature...
March 2018: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29298242/contemporary-management-of-high-grade-renal-trauma-results-from-the-american-association-for-the-surgery-of-trauma-genitourinary-trauma-study
#12
Sorena Keihani, Yizhe Xu, Angela P Presson, James M Hotaling, Raminder Nirula, Joshua Piotrowski, Christopher M Dodgion, Cullen M Black, Kaushik Mukherjee, Bradley J Morris, Sarah Majercik, Brian P Smith, Ian Schwartz, Sean P Elliott, Erik S DeSoucy, Scott Zakaluzny, Peter B Thomsen, Bradley A Erickson, Nima Baradaran, Benjamin N Breyer, Brandi Miller, Richard A Santucci, Matthew M Carrick, Timothy Hewitt, Frank N Burks, Jurek F Kocik, Reza Askari, Jeremy B Myers
BACKGROUND: The rarity of renal trauma limits its study and the strength of evidence-based guidelines. Although management of renal injuries has shifted toward a nonoperative approach, nephrectomy remains the most common intervention for high-grade renal trauma (HGRT). We aimed to describe the contemporary management of HGRT in the United States and also evaluate clinical factors associated with nephrectomy after HGRT. METHODS: From 2014 to 2017, data on HGRT (American Association for the Surgery of Trauma grades III-V) were collected from 14 participating Level-1 trauma centers...
March 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29280423/anemia-was-an-uncommon-complication-of-severe-malaria-in-a-high-transmission-rural-area-of-western-uganda
#13
Ross Boyce, Raquel Reyes, Corinna Keeler, Michael Matte, Moses Ntaro, Edgar Mulogo, Mark J Siedner
The clinical epidemiology of severe malaria among patients presenting to peripheral health centers has not been well described. We conducted a prospective, observational cohort study to describe the epidemiology and clinical manifestations of severe malaria in a highland area of declining transmission intensity in Western Uganda. Individuals presenting with a history of fever were screened with a malaria rapid diagnostic test (RDT). We prepared blood smears and conducted clinical and laboratory testing for those with a positive RDT...
March 2018: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/29229321/the-role-of-aspirin-heparin-and-other-interventions-in-the-prevention-and-treatment-of-fetal-growth-restriction
#14
REVIEW
Katie M Groom, Anna L David
Fetal growth restriction and related placental pathologies such as preeclampsia, stillbirth, and placental abruption are believed to arise in early pregnancy when inadequate remodeling of the maternal spiral arteries leads to persistent high-resistance and low-flow uteroplacental circulation. The consequent placental ischaemia, reperfusion injury, and oxidative stress are associated with an imbalance in angiogenic/antiangiogenic factors. Many interventions have centered on the prevention and/or treatment of preeclampsia with results pertaining to fetal growth restriction and small-for-gestational-age pregnancy often included as secondary outcomes because of the common pathophysiology...
February 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29176758/early-optimal-parenteral-nutrition-and-metabolic-acidosis-in-very-preterm-infants
#15
Francesco Bonsante, Jean-Bernard Gouyon, Pierre-Yves Robillard, Béatrice Gouyon, Silvia Iacobelli
BACKGROUND: It is currently recognized that an optimized nutritional approach, consisting of an early and substantial supply of protein and energy by parenteral route, may be beneficial for very low birth weight infants and recent guidelines endorse this strategy. However, the impact of the enhanced parenteral nutrition (PN) on acid-basic balance has never been investigated. The aim of the present study is to assess the effect of nutrient intake on acid-base homeostasis in a large population of preterm infants on PN...
2017: PloS One
https://www.readbyqxmd.com/read/29106612/mediterranean-diet-as-the-diet-of-choice-for-patients-with-chronic-kidney-disease
#16
Philippe Chauveau, Michel Aparicio, Vincenzo Bellizzi, Katrina Campbell, Xu Hong, Lina Johansson, Anne Kolko, Pablo Molina, Siren Sezer, Christoph Wanner, Pieter M Ter Wee, Daniel Teta, Denis Fouque, Juan J Carrero
Traditional dietary management of chronic kidney disease (CKD) focuses on the quantity within the diet of energy and protein, and the restriction of single micronutrients, with little mention of dietary quality. Dietary patterns that are more plant-based, lower in meat (including processed meat), sodium and refined sugar, and have a higher content of grains and fibres are now included in multiple clinical guidelines for chronic disease prevention. The Mediterranean diet (MD) has been associated with reduced cardiovascular disease incidence in both observational and interventional studies...
July 2, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29030467/metabolic-acidosis-and-subclinical-metabolic-acidosis-in-ckd
#17
Kalani L Raphael
Metabolic acidosis is not uncommon in CKD and is linked with bone demineralization, muscle catabolism, and higher risks of CKD progression and mortality. Clinical practice guidelines recommend maintaining serum total CO2 at ≥22 mEq/L to help prevent these complications. Although a definitive trial testing whether correcting metabolic acidosis improves clinical outcomes has not been conducted, results from small, single-center studies support this notion. Furthermore, biologic plausibility supports the notion that a subset of patients with CKD have acid-mediated organ injury despite having a normal serum total CO2 and might benefit from oral alkali before overt acidosis develops...
February 2018: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28940961/peri-operative-continuation-of-metformin-does-not-improve-glycaemic-control-in-patients-with-type-2-diabetes-a-randomized-controlled-trial
#18
A H Hulst, J A W Polderman, E Ouweneel, A J Pijl, M W Hollmann, J H DeVries, B Preckel, J Hermanides
Historically, metformin was withheld before surgery for fear of metformin-associated lactic acidosis. Currently, however, this risk is deemed to be low and guidelines have moved towards the continuation of metformin. We hypothesized that continuing metformin peri-operatively would lower postoperative serum glucose level without an effect on plasma lactate levels. We performed a single-blind multicentre randomized controlled trial in people with type 2 diabetes mellitus scheduled for non-cardiac surgery and continued (MF+ group) or withheld (MF- group) metformin before surgery...
March 2018: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28930639/fifty-years-of-research-in-ards-vt-selection-in-acute-respiratory-distress-syndrome
#19
REVIEW
Sarina K Sahetya, Jordi Mancebo, Roy G Brower
Mechanical ventilation (MV) is critical in the management of many patients with acute respiratory distress syndrome (ARDS). However, MV can also cause ventilator-induced lung injury (VILI). The selection of an appropriate Vt is an essential part of a lung-protective MV strategy. Since the publication of a large randomized clinical trial demonstrating the benefit of lower Vts, the use of Vts of 6 ml/kg predicted body weight (based on sex and height) has been recommended in clinical practice guidelines. However, the predicted body weight approach is imperfect in patients with ARDS because the amount of aerated lung varies considerably due to differences in inflammation, consolidation, flooding, and atelectasis...
December 15, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28923612/deceased-organ-donation-from-pediatric-donors-does-the-literature-really-help-us-implication-for-more-powerful-guidelines
#20
M Mojtabaee, F Sadegh Beigee, F Ghorbani
BACKGROUND: Brain-dead pediatric donors have always been the focus of attention because of the higher quality, utility, and possibility of their organ donation. However, donors under the age of 5 years always necessitate making more challenging management efforts, which are not clearly implied in most parts of the guidelines. METHODS: The data obtained from 79 brain-dead pediatric donors of the Organ Procurement Unit of Masih Daneshvari Hospital, Tehran, Iran, were assessed...
October 2017: Transplantation Proceedings
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