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https://www.readbyqxmd.com/read/29222218/fat-embolism-a-rare-cause-of-perioperative-renal-transplant-dysfunction
#1
Jemima Scott, Neil Collin, Richard Baker, Rommel Ravanan
Fat embolism is a recognised complication of bony injury and orthopaedic surgery, commonly involving the long bones and pelvis. We report on the case of a 68-year-old renal transplant recipient who developed acute kidney injury following surgical stabilisation of metastatic carcinoma of the acetabulum and replacement of the proximal femur. A CT renal angiogram demonstrated a large fat embolus in the inferior vena cava (IVC) and left iliac veins below the level of IVC filter, with impaired renal perfusion. The risks of open or endovascular lipothrombectomy were felt to outweigh the potential benefits...
December 7, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29218620/the-impact-of-injector-based-contrast-agent-administration-in-time-resolved-mra
#2
Johannes Budjan, Ulrike I Attenberger, Stefan O Schoenberg, Hubertus Pietsch, Gregor Jost
OBJECTIVES: Time-resolved contrast-enhanced MR angiography (4D-MRA), which allows the simultaneous visualization of the vasculature and blood-flow dynamics, is widely used in clinical routine. In this study, the impact of two different contrast agent injection methods on 4D-MRA was examined in a controlled, standardized setting in an animal model. METHODS: Six anesthetized Goettingen minipigs underwent two identical 4D-MRA examinations at 1.5 T in a single session...
December 7, 2017: European Radiology
https://www.readbyqxmd.com/read/29217491/intravoxel-incoherent-motion-diffusion-weighted-imaging-for-the-assessment-of-renal-fibrosis-of-chronic-kidney-disease-a-preliminary-study
#3
Wei Mao, Jianjun Zhou, Mengsu Zeng, Yuqin Ding, Lijie Qu, Caizhong Chen, Xiaoqiang Ding, Yaqiong Wang, Caixia Fu, Feng Gu
PURPOSE: To investigate the potential of Intravoxel incoherent motion diffusion-weighted imaging(IVIM-DWI) for the assessment of renal fibrosis in chronic kidney disease (CKD), using histopathology as a reference standard. METHODS: Eighty-five CKD patients and twenty healthy volunteers were recruited in this study. IVIM-DWI was performed in all of the participants, and all of the CKD patients underwent renal biopsy. The mean values of the true diffusion coefficient (D), pseudo diffusion coefficient (D*) and perfusion fraction (f) in the renal cortex and medulla were compared between the CKD patients and healthy volunteers...
December 4, 2017: Magnetic Resonance Imaging
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/29212810/heme-oxygenase-1-is-a-potent-inhibitor-of-placental-ischemia-mediated-endothelin-1-production-in-cultured-human-glomerular-endothelial-cells
#5
Bhavisha A Bakrania, Frank T Spradley, Simon C Satchell, David E Stec, John M Rimoldi, Rama S V Gadepalli, Joey P Granger
Preeclampsia is a pregnancy-specific disorder of maternal hypertension and reduced renal hemodynamics linked to reduced endothelial function. Placental ischemia is thought to be the culprit of this disease, as it causes the release of factors like tumor necrosis factor (TNF)-α that induce vascular endothelin-1 (ET-1) production. Interestingly, placental ischemia-induced hypertension in rats (reduced uterine perfusion pressure, RUPP model) is abolished by ETA receptor blockade, suggesting a critical role for ET-1...
December 6, 2017: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
https://www.readbyqxmd.com/read/29211403/the-role-of-fetal-maternal-microchimerism-as-a-natural-born-healer-in-integrity-improvement-of-maternal-damaged-kidney
#6
Abdol-Mohammad Kajbafzadeh, Shabnam Sabetkish, Nastaran Sabetkish
PURPOSE: To identify the fetal stem cell (FSC) response to maternal renal injury with emphasis on renal integrity improvement and Y chromosome detection in damaged maternal kidney. MATERIALS AND METHODS: Eight non-green fluorescent protein (GFP) transgenic Sprague- Dawley rats were mated with GFP-positive transgenic male rats. Renal damage was induced on the right kidney at gestational day 11. The same procedure was performed in eight non-pregnant rats as control group...
December 7, 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/29210064/normothermic-machine-perfusion-for-the-assessment-and-transplantation-of-declined-human-kidneys-from-donation-after-circulatory-death-donors
#7
S A Hosgood, E Thompson, T Moore, C H Wilson, M L Nicholson
BACKGROUND: A significant proportion of donation after circulatory death (DCD) kidneys are declined for transplantation because of concerns over their quality. Ex vivo normothermic machine perfusion (NMP) provides a unique opportunity to assess the quality of a kidney and determine its suitability for transplantation. METHODS: In phase 1 of this study, declined human DCD kidneys underwent NMP assessment for 60 min. Kidneys were graded 1-5 using a quality assessment score (QAS) based on macroscopic perfusion, renal blood flow and urine output during NMP...
December 6, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/29209891/renal-response-to-anaphylaxis-in-anesthetized-rats-and-isolated-perfused-rat-kidneys-roles-of-nitric-oxide
#8
Kiyotaka Mukai, Yuhichi Kuda, Toshishige Shibamoto, Mamoru Tanida, Yasutaka Kurata, Hitoshi Yokoyama
We determined the renal responses to anaphylaxis and the effects of a nitric oxide synthesis inhibitor, L-NAME, in anesthetized rats and isolated perfused rat kidneys. After the ovalbumin antigen injection, the sensitized rats showed transient and substantial decreases in mean blood pressure and renal blood flow and an increase in renal vascular resistance. Creatinine clearance, a measure of renal function, decreased to 53% baseline at 2 h after antigen. L-NAME pretreatment significantly enhanced the antigen-induced renal vasoconstriction and renal dysfunction...
December 5, 2017: Journal of Physiological Sciences: JPS
https://www.readbyqxmd.com/read/29208215/plasma-potassium-concentrations-in-neonatal-diarrhoeic-calves-are-correlated-with-serum-aldosterone-concentrations-but-not-with-insulin-concentrations
#9
Florian M Trefz, Ingrid Lorenz
Hyperkalaemia is a clinically relevant electrolyte imbalance in neonatal diarrhoeic calves which was previously associated with severe dehydration and acidaemia. The present study assessed the association of plasma potassium (cK) with serum aldosterone and insulin concentrations, since these hormones are involved in the regulation of potassium homeostasis. Serum aldosterone (rs=0.62), but not insulin concentrations (rs=0.22) were closely correlated to cK in 123 hospitalised neonatal diarrhoeic calves. Median values for serum aldosterone concentrations in 38 hyperkalaemic calves (cK>5...
December 2017: Veterinary Journal
https://www.readbyqxmd.com/read/29207099/n-acetylcysteine-ameliorates-contrast%C3%A2-induced-kidney-injury-in-rats-with-unilateral-hydronephrosis
#10
Qiang Xia, Chunxiao Liu, Xia Zheng
The aim of the present study was to investigate the protective effects of N‑acetylcysteine (NAC) on contrast‑induced acute kidney injury in rats with unilateral hyronephrosis. Eighty‑two male Sprague Dawley rats were randomized to undergo sham operation (n=14) or unilateral ureteral obstruction (UUO) (n=68). After 3 weeks, the UUO animals were randomized to three groups: NAC gastric perfusion, UUO+iohexol+NAC (n=24); normal saline perfusion, UUO+iohexol (n=24); and controls, UUO (n=20). After 3 days, UUO+iohexol+NAC and UUO+iohexol rats were injected with iohexol...
November 21, 2017: Molecular Medicine Reports
https://www.readbyqxmd.com/read/29204685/methylene-blue-protects-the-isolated-rat-lungs-from-ischemia-reperfusion-injury-by-attenuating-mitochondrial-oxidative-damage
#11
Wen-Fang Tian, Si Zeng, Qiong Sheng, Jun-Liang Chen, Ping Weng, Xiao-Tong Zhang, Jia-Jia Yuan, Qing-Feng Pang, Zhi-Qiang Wang
INTRODUCTION: Impaired mitochondrial function is a key factor attributing to the lung ischemia reperfusion injury (LIRI). Methylene blue (MB) has been reported to attenuate brain and renal ischemia-reperfusion injury. We hypothesized that MB also could have a protective effect against LIRI by preventing mitochondrial oxidative damage. METHODS: Isolated rat lungs were assigned to the following four groups (n = 6): a sham group: perfusion for 105 min without ischemia; I/R group: shutoff of perfusion and ventilation for 45 min followed by reperfusion for 60 min; and I/R + MB group and I/R + glutathione (GSH) group: 2 mg/kg MB or 4 μM glutathione were intraperitoneally administered for 2 h, and followed by 45 min of ischemia and 60 min of reperfusion...
December 4, 2017: Lung
https://www.readbyqxmd.com/read/29199512/long-term-renal-and-overall-survival-of-critically-ill-patients-with-acute-renal-injury-who-received-continuous-renal-replacement-therapy
#12
Lingping Wu, Ping Zhang, Yi Yang, Hua Jiang, Yongchun He, Chunping Xu, Huijuan Yan, Qi Guo, Qun Luo, Jianghua Chen
BACKGROUND: Acute kidney injury (AKI) is associated with the increased short-term mortality of critically ill patients on continuous renal replacement therapy (CRRT). The aim of this research was to evaluate the association of kidney function at discharge with the long-term renal and overall survival of critically ill patients with AKI who were on CRRT in an intensive care unit (ICU). METHODS: We retrospectively collected data for critically ill patients with AKI who were admitted to ICU on CRRT at a tertiary metropolitan hospital in China between 2008 and 2013...
November 2017: Renal Failure
https://www.readbyqxmd.com/read/29193529/renal-ultrasound-and-doppler-parameters-as-markers-of-renal-function-and-histopathological-damage-in-children-with-ckd
#13
Happy Sawires, Doaa Salah, Rania Hachem, Wesam Ismail, Amr Salem, Osama Botros, Hadeel Seif
BACKGROUND: Doppler ultrasonography can be used to assess the progression of vascular (arterial sclerosis) and parenchymal (glomerular sclerosis and crescents) renal damage. The aim of this study was to evaluate the significance of some sonographic and Doppler parameters as non-invasive markers of glomerular filtration rate (GFR) and renal histopathological damage in children. METHODOLOGY: A cohort of 84 children were enrolled in a case-control study (42 with CKD stages 2-5 and 42 healthy children)...
November 30, 2017: Nephrology
https://www.readbyqxmd.com/read/29193158/terlipressin-induced-modifications-of-doppler-ultrasound-signals-of-systemic-arteries-in-preterm-infants-with-vasoactive-resistant-patent-ductus-arteriosus-a-pilot-study
#14
M Radicioni, V Bini, G M Campus, P G Camerini
PURPOSE: To study the effects of terlipressin (TP) infusion on systemic perfusion, estimated with pulsed-wave Doppler ultrasonography of systemic arteries, in a population of extremely low birth-weight (ELBW) preterm infants with vasoactive-resistant ductus arteriosus. METHODS: This prospective, observational cohort included, during five years, 12 ELBW infants with hemodynamically significant patent ductus arteriosus and absent or reversed diastolic flow at Doppler ultrasonography of systemic arteries, despite treatment and high-dose vasoactive support...
November 28, 2017: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/29190218/validation-of-a-real-time-minute-to-minute-urine-output-monitor-and-the-feasibility-of-its-clinical-use-for-patients-undergoing-cardiac-surgery
#15
Aaron J Chang, Yohei Nomura, Viachaslau M Barodka, Daijiro Hori, Jonathan T Magruder, Nevin M Katz, Dan E Berkowitz, Charles W Hogue
Acute kidney injury after cardiac surgery is associated with increased morbidity and mortality. Methods for measuring urine output in real time may better ensure renal perfusion perioperatively in contrast to the current standard of care where urine output is visually estimated after empiric epochs of time. In this study, we describe an accurate method for monitoring urine output continuously during cardiopulmonary bypass. This may provide a means for setting patient-specific targets for blood pressure and cardiopulmonary bypass flow as a potential strategy to reduce the risk for acute kidney injury...
December 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29187644/nanoparticle-targeting-to-the-endothelium-during-normothermic-machine-perfusion-of-human-kidneys
#16
Gregory T Tietjen, Sarah A Hosgood, Jenna DiRito, Jiajia Cui, Deeksha Deep, Eric Song, Jan R Kraehling, Alexandra S Piotrowski-Daspit, Nancy C Kirkiles-Smith, Rafia Al-Lamki, Sathia Thiru, J Andrew Bradley, Kourosh Saeb-Parsy, John R Bradley, Michael L Nicholson, W Mark Saltzman, Jordan S Pober
Ex vivo normothermic machine perfusion (NMP) is a new clinical strategy to assess and resuscitate organs likely to be declined for transplantation, thereby increasing the number of viable organs available. Short periods of NMP provide a window of opportunity to deliver therapeutics directly to the organ and, in particular, to the vascular endothelial cells (ECs) that constitute the first point of contact with the recipient's immune system. ECs are the primary targets of both ischemia-reperfusion injury and damage from preformed antidonor antibodies, and reduction of perioperative EC injury could have long-term benefits by reducing the intensity of the host's alloimmune response...
November 29, 2017: Science Translational Medicine
https://www.readbyqxmd.com/read/29178439/renal-parenchyma-impairment-characterization-in-partial-unilateral-ureteral-obstruction-in-mice-with-intravoxel-incoherent-motion-mri
#17
Maguelonne Pons, Benjamin Leporq, Liza Ali, Marianne Alison, Miguel Albuquerque, Michel Peuchmaur, Marie-Laurence Poli Mérol, Ulrich Blank, Simon A Lambert, Alaa El Ghoneimi
Ureteropelvic junction obstruction constitutes a major cause of progressive pediatric renal disease. The biological mechanisms underlying the renal response to obstruction can be investigated using a clinically relevant mouse model of partial unilateral ureteral obstruction (pUUO). Renal function and kidney morphology data can be evaluated using renal ultrasound, scintigraphy and uro-magnetic resonance imaging (uro-MRI), but these methods are poorly linked to histological change and not all are quantitative...
November 27, 2017: NMR in Biomedicine
https://www.readbyqxmd.com/read/29178250/sublingual-functional-capillary-rarefaction-in-chronic-heart-failure
#18
Patricia P Wadowski, Martin Hülsmann, Christian Schörgenhofer, Irene M Lang, Raphael Wurm, Thomas Gremmel, Renate Koppensteiner, Barbara Steinlechner, Michael Schwameis, Bernd Jilma
BACKGROUND AND OBJECTIVE: Microcirculatory changes contribute to clinical symptoms and disease progression in chronic heart failure (CHF). A depression of coronary flow reserve is associated with a lower myocardial capillary density in biopsies. We hypothesized that changes in cardiac microcirculation might also be reflected by a systemic reduction of capillaries and visualized by sublingual videomicroscopy. The aim was to study in vivo capillary density and glycocalyx dimensions in patients with CHF vs...
November 25, 2017: European Journal of Clinical Investigation
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
#19
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/29174044/repeatability-of-contrast-enhanced-ultrasonography-of-the-kidneys-in-healthy-cats
#20
Emmelie Stock, Luc Duchateau, Jimmy H Saunders, Veerle Volckaert, Ingeborgh Polis, Katrien Vanderperren
Contrast-enhanced ultrasound can be used to image and quantify tissue perfusion. It holds great potential for the use in the diagnosis of various diffuse renal diseases in both human and veterinary medicine. Nevertheless, the technique is known to have an inherent relatively high variability, related to various factors associated with the patient, the contrast agent and machine settings. Therefore, the aim of this study was to assess week-to-week intra- and inter-cat variation of several perfusion parameters obtained with CEUS of both kidneys of 12 healthy cats...
November 21, 2017: Ultrasound in Medicine & Biology
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