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https://www.readbyqxmd.com/read/28231640/mind-the-gap-mechanisms-regulating-the-endothelial-barrier
#1
REVIEW
Mariya Y Radeva, Jens Waschke
The endothelial barrier consists of intercellular contacts localized in the cleft between endothelial cells, which is covered by the glycocalyx in a sieve-like manner. Both types of barrier-forming junctions, i.e. the adherens junction (AJ) serving mechanical anchorage and mechanotransduction and the tight junction (TJ) sealing the intercellular space to limit paracelullar permeability, are tethered to the actin cytoskeleton. Under resting conditions, the endothelium thereby builds a selective layer controlling the exchange of fluid and solutes with the surrounding tissue...
February 23, 2017: Acta Physiologica
https://www.readbyqxmd.com/read/28223424/hsp70-inhibition-synergistically-enhances-the-effects-of-magnetic-fluid-hyperthermia-in-ovarian-cancer
#2
Karem A Court, Hiroto Hatakeyama, Sherry Y Wu, Mangala S Lingegowda, Cristian Rodriguez-Aguayo, Gabriel Lopez-Berestein, Lee Ju-Seog, Carlos Rinaldi, Eduardo J Juan, Anil K Sood, Madeline Torres-Lugo
Hyperthermia has been investigated as a potential treatment for cancer. However, specificity in hyperthermia application remains a significant challenge. Magnetic fluid hyperthermia (MFH) may be an alternative to surpass such a challenge, but implications of MFH at the cellular level are not well understood. Therefore, the present work focused on the examination of gene expression after MFH treatment and using such information to identify target genes that when inhibited could produce an enhanced therapeutic outcome after MFH...
February 21, 2017: Molecular Cancer Therapeutics
https://www.readbyqxmd.com/read/28219612/hyperoxia-and-hypertonic-saline-in-patients-with-septic-shock-hypers2s-a-two-by-two-factorial-multicentre-randomised-clinical-trial
#3
Pierre Asfar, Frédérique Schortgen, Julie Boisramé-Helms, Julien Charpentier, Emmanuel Guérot, Bruno Megarbane, David Grimaldi, Fabien Grelon, Nadia Anguel, Sigismond Lasocki, Matthieu Henry-Lagarrigue, Frédéric Gonzalez, François Legay, Christophe Guitton, Maleka Schenck, Jean Marc Doise, Jérôme Devaquet, Thierry Van Der Linden, Delphine Chatellier, Jean Philippe Rigaud, Jean Dellamonica, Fabienne Tamion, Ferhat Meziani, Alain Mercat, Didier Dreyfuss, Valérie Seegers, Peter Radermacher
BACKGROUND: There is insufficient research into the use of mechanical ventilation with increased inspiratory oxygen concentration (FiO2) and fluid resuscitation with hypertonic saline solution in patients with septic shock. We tested whether these interventions are associated with reduced mortality. METHODS: This two-by-two factorial, multicentre, randomised, clinical trial (HYPERS2S) recruited patients aged 18 years and older with septic shock who were on mechanical ventilation from 22 centres in France...
February 14, 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/28217612/isolated-pulmonary-hydatid-cyst-misinterpreted-as-metastatic-pulmonary-lesion-in-an-operated-case-of-carcinoma-breast-in-young-female
#4
Ravish Kshatriya, Dhaval Prajapati, Nimit Khara, Rajiv Paliwal, Satish Patel
Hydatidosis is caused by Echinococcus granulosus. Humans may be infected incidentally as intermediate host by the accidental consumption of soil, water, or food contaminated by fecal matter of an infected animal. Hydatidosis is one of the most symptomatic parasitic infections in various livestock - raising countries. Lung is the second most commonly affected organ following the liver. The symptoms depend on the size and site of the lesion. It can present as an asymptomatic pulmonary lesion to hemoptysis, chest pain, coughing anaphylaxis, and shock...
July 2016: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/28217595/impact-of-pre-hospital-care-on-the-outcome-of-children-arriving-with-agonal-breathing-to-a-pediatric-emergency-service-in-south-india
#5
Debasis Das Adhikari, Krishna Mahathi, Urmi Ghosh, Indira Agarwal, Anila Chacko, Ebor Jacob, Kala Ebenezer
BACKGROUND: Data on the prehospital interventions received by critically ill children at arrival to Paediatric Emergency Services (PES) is limited in developing countries. This study aims to describe the pre-hospital care scenario, transport and their impact on outcome in non-traumatic, acutely ill children presenting in PES with agonal breathing. METHODS: Prospective observational study done on children aged below 15 years arriving in PES with agonal breathing due to non-trauma related causes...
July 2016: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/28216569/micromachined-fluid-inertial-sensors
#6
REVIEW
Shiqiang Liu, Rong Zhu
Micromachined fluid inertial sensors are an important class of inertial sensors, which mainly includes thermal accelerometers and fluid gyroscopes, which have now been developed since the end of the last century for about 20 years. Compared with conventional silicon or quartz inertial sensors, the fluid inertial sensors use a fluid instead of a solid proof mass as the moving and sensitive element, and thus offer advantages of simple structures, low cost, high shock resistance, and large measurement ranges while the sensitivity and bandwidth are not competitive...
February 14, 2017: Sensors
https://www.readbyqxmd.com/read/28215154/stress-and-salivary-glands
#7
Beáta Kerémi, Anita Beck, Tibor Károly Fábián, Gábor Fábián, Géza Szabó, Ákos Nagy, Gábor Varga
Salivary glands produce a bicarbonate-rich fluid containing digestive and protective proteins and other components to be delivered into the gastrointestinal tract. Its function is under strict control of the autonomic nervous system. Salivary electrolyte and fluid secretion is primarily controlled by parasympathetic activity, while protein secretion is primaily triggered by sympathetic stimulation. Stress activates the hypothalamic - pituitary - adrenal axis. The peripheral limb of this axis is the efferent sympathetic/adrenomedullary system...
February 15, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28202124/-effect-of-heat-shock-factor-1-on-airway-hyperresponsiveness-and-airway-inflammation-in-mice-with-allergic-asthma
#8
Jing Wang, Li-Hong Xin, Wei Cheng, Zhen Wang, Wen Zhang
OBJECTIVE: To investigate the effect of heat shock factor 1 (HSF1) on airway hyperresponsiveness and airway inflammation in mice with asthma and possible mechanisms. METHODS: A total of 36 mice were randomly divided into four groups: control, asthma, HSF1 small interfering RNA negative control (siHSF1-NC), and siHSF1 intervention (n=9 each). Ovalbumin (OVA) sensitization and challenge were performed to induce asthma in the latter three groups. The mice in the siHSF1-NC and siHSF1 groups were treated with siHSF1-NC and siHSF1, respectively...
February 2017: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/28159434/-and-if-it-happened-to-children-adapting-medical-care-during-terrorist-attacks-with-multiple-pediatric-victims
#9
L Alix-Séguin, N Lodé, G Orliaguet, E Chamorro, F Kerroué, C Lorge, A Moreira
In light of the recent terrorist attacks in Europe, we need to reconsider the organization of rescue and medical management and plan for an attack involving multiple pediatric victims. To ensure quick surgical management, but also to minimize risk for on-site teams (direct threats from secondary terrorist attacks targeting deployed emergency services), it is crucial to evacuate patients in a swift but orderly fashion. Children are vulnerable targets in terrorist attacks. Their anatomical and physiological characteristics make it likely that pediatric victims will suffer more brain injuries and require more, often advanced, airway management...
January 31, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28159011/fluids-and-sepsis-changing-the-paradigm-of-fluid-therapy-a-case-report
#10
Hori Hariyanto, Corry Quando Yahya, Monika Widiastuti, Primartanto Wibowo, Oloan Eduard Tampubolon
BACKGROUND: Over the past 16 years, sepsis management has been guided by large-volume fluid administration to achieve certain hemodynamic optimization as advocated in the Rivers protocol. However, the safety of such practice has been questioned because large-volume fluid administration is associated with fluid overload and carries the worst outcome in patients with sepsis. Researchers in multiple studies have declared that using less fluid leads to increased survival, but they did not describe how to administer fluids in a timely and appropriate manner...
February 4, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28150304/effects-of-fluid-restriction-on-measures-of-circulatory-efficacy-in-adults-with-septic-shock
#11
P B Hjortrup, N Haase, J Wetterslev, T Lange, H Bundgaard, B S Rasmussen, N Dey, E Wilkman, L Christensen, D Lodahl, M Bestle, A Perner
BACKGROUND: The haemodynamic consequences of fluid resuscitation in septic shock have not been fully elucidated. Therefore, we assessed circulatory effects in the first 24 h of restriction of resuscitation fluid as compared to standard care in intensive care unit (ICU) patients with septic shock. METHODS: This was a post-hoc analysis of the multicentre CLASSIC randomised trial in which patients with septic shock, who had received the initial fluid resuscitation, were randomised to a protocol restricting resuscitation fluid or a standard care protocol in nine ICUs...
February 1, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28149028/comparative-evaluation-of-central-venous-pressure-and-sonographic-inferior-vena-cava-variability-in-assessing-fluid-responsiveness-in-septic-shock
#12
Manjri Garg, Jyotsna Sen, Sandeep Goyal, Dhruva Chaudhry
OBJECTIVE: Fluid infusion, the most critical step in the resuscitation of patients with septic shock, needs preferably continuous invasive hemodynamic monitoring. The study was planned to evaluate the efficacy of ultrasonographically measured inferior vena cava collapsibility index (IVC CI) in comparison to central venous pressure (CVP) in predicting fluid responsiveness in septic shock. MATERIALS AND METHODS: Thirty-six patients of septic shock requiring ventilatory support (invasive/noninvasive) were included...
December 2016: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28149027/sustained-low-efficiency-dialysis-in-septic-shock-hemodynamic-tolerability-and-efficacy
#13
Shakti Bedanta Mishra, Ratender Kumar Singh, Arvind Kumar Baronia, Banani Poddar, Afzal Azim, Mohan Gurjar
AIM OF THE STUDY: Acute kidney injury (AKI) in septic shock has poor outcomes. Sustained low-efficiency dialysis (SLED) is increasingly replacing continuous renal replacement therapy as the preferred modality in Intensive Care Units (ICUs). However, the essential aspects of hemodynamic tolerability and efficacy of SLED in septic shock AKI has been minimally studied. PATIENTS AND METHODS: We describe hemodynamic tolerability using modified vasopressor index (VI) and vasopressor dependency (VD) and efficacy using a combination of Kt/v, correction of acidosis, electrolyte, and fluid overload...
December 2016: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28148289/a-rare-case-of-dengue-encephalopathy-complicating-a-term-pregnancy
#14
Lavanya Rajagopala, Ravindra L Satharasinghe, Madhava Karunarathna
BACKGROUND: Dengue fever has an expanded clinical spectrum ranging from an asymptomatic infection to life threatening dengue hemorrhagic fever and refractory shock. Dengue infection in pregnancy can be a diagnostic dilemma, particularly considering the physiological changes in pregnancy and the obstetric complications encountered in clinical practice. Hence the knowledge of its diagnosis and management in its atypical presentations is of paramount importance. Here we report an unusual case of uncomplicated dengue encephalopathy in a term mother, probably the first to be reported from the Indian subcontinent...
February 2, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28144779/focused-cardiac-ultrasound-in-the-early-resuscitation-of-severe-sepsis-and-septic-shock-a-prospective-pilot-study
#15
Hiroshi Sekiguchi, Yohei Harada, Hector R Villarraga, Sunil V Mankad, Ognjen Gajic
PURPOSE: Point-of-care ultrasonography has been increasingly used in the care of critically ill patients; however, reports on its use during active resuscitation are limited. The aim of this study was to investigate the true impact of focused cardiac ultrasound (FCU) during the management of sepsis with early (6-h) resuscitation. METHODS: A prospective pilot observational study was conducted at an academic medical center from March 2011 through July 2012. Patients undergoing resuscitation for severe sepsis or septic shock were prospectively enrolled at medical and combined medical-surgical intensive care units...
January 31, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28135411/use-of-cryopoor-plasma-for-albumin-replacement-and-continuous-antimicrobial-infusion-for-treatment-of-septic-peritonitis-in-a-dog
#16
Meaghan K Ropski, Julien Guillaumin, Andrea A Monnig, Katy Townsend, Mary A McLoughlin
OBJECTIVE: To report the successful management of a dog with septic peritonitis and septic shock secondary to enterectomy dehiscence using novel techniques for identification of intestinal dehiscence and for septic shock treatment. CASE SUMMARY: A 5-year-old castrated male Bernese Mountain Dog presented for lethargy 6 days following enterotomy for foreign body obstruction. Septic peritonitis was identified due to dehiscence of the enterotomy site, and resection and anastomosis were performed using a gastrointestinal anastomosis and thoracoabdominal stapling device...
January 30, 2017: Journal of Veterinary Emergency and Critical Care
https://www.readbyqxmd.com/read/28134396/-metabolic-acidosis
#17
Giuseppe Regolisti, Filippo Fani, Riccardo Antoniotti, Giuseppe Castellano, Elena Cremaschi, Paolo Greco, Elisabetta Parenti, Santo Morabito, Alice Sabatino, Enrico Fiaccadori
Metabolic acidosis is frequently observed in clinical practice, especially among critically ill patients and/or in the course of renal failure. Complex mechanisms are involved, in most cases identifiable by medical history, pathophysiology-based diagnostic reasoning and measure of some key acid-base parameters that are easily available or calculable. On this basis the bedside differential diagnosis of metabolic acidosis should be started from the identification of the two main subtypes of metabolic acidosis: the high anion gap metabolic acidosis and the normal anion gap (or hyperchloremic) metabolic acidosis...
November 2016: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28130687/fluid-administration-in-severe-sepsis-and-septic-shock-patterns-and-outcomes-an-analysis-of-a-large-national-database
#18
Paul E Marik, Walter T Linde-Zwirble, Edward A Bittner, Jennifer Sahatjian, Douglas Hansell
PURPOSE: The optimal strategy of fluid resuscitation in the early hours of severe sepsis and septic shock is controversial, with both an aggressive and conservative approach being recommended. METHODS: We used the 2013 Premier Hospital Discharge database to analyse the administration of fluids on the first ICU day, in 23,513 patients with severe sepsis and septic shock, who were admitted to an ICU from the emergency department. Day 1 fluid was grouped into categories 1 L wide, starting with 1-1...
January 27, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28127487/spontaneous-rupture-of-a-leiomyoma-causing-life-threatening-intra-abdominal-hemorrhage
#19
Melissa Schwartz, Kristin Powell
Background. Uterine fibroids are common benign tumors in women. Clinical manifestations are well known. Acute complications necessitating emergent surgical intervention are rare. Case. We report a case of a 53-year-old woman with a history of uterine fibroids presenting with acute-onset severe abdominal pain. Imaging indicated massive free fluid and a large partially solid uterine mass. Vitals were consistent with hypovolemic shock. Examination revealed a surgical abdomen. She underwent an emergent laparotomy and total hysterectomy...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28127476/vasopressin-bolus-protocol-compared-to-desmopressin-ddavp-for-managing-acute-postoperative-central-diabetes-insipidus-and-hypovolemic-shock
#20
Anukrati Shukla, Syeda Alqadri, Ashley Ausmus, Robert Bell, Premkumar Nattanmai, Christopher R Newey
Introduction. Management of postoperative central diabetes insipidus (DI) can be challenging from changes in volume status and serum sodium levels. We report a case successfully using a dilute vasopressin bolus protocol in managing hypovolemic shock in acute, postoperative, central DI. Case Report. Patient presented after bifrontal decompressive craniotomy for severe traumatic brain injury. He developed increased urine output resulting in hypovolemia and hypernatremia. He was resuscitated with intravenous fluids including a dilute vasopressin bolus protocol...
2017: Case Reports in Endocrinology
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