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Targetted temperature management

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https://www.readbyqxmd.com/read/29138889/-hypothermia-induced-ecg-changes-characteristic-but-not-specific
#1
G Michels, S Ney, F Hoffmann, J Brugada, R Pfister, K Brockmeier, A Sultan
Hypothermia-induced J‑ or so-called Osborn waves can be detected under therapeutic hypothermia in approximately 20-40% of cases. The occurrence of J‑waves in the context of the targeted temperature management after cardiopulmonary resuscitation is characteristic, but not pathognomonic for hypothermia. An electrocardiographic diagnosis under hypothermia after cardiac arrest should always be done with caution due to the various hypothermia-associated electromechanical changes of the myocardium.
November 14, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/29135522/determinants-of-long-term-neurological-recovery-patterns-relative-to-hospital-discharge-among-cardiac-arrest-survivors
#2
Sachin Agarwal, Alex Presciutti, William Roth, Elizabeth Matthews, Ashley Rodriguez, David J Roh, Soojin Park, Jan Claassen, Ronald M Lazar
OBJECTIVE: To explore factors associated with neurological recovery at 1 year relative to hospital discharge after cardiac arrest. DESIGN: Observational, retrospective review of a prospectively collected cohort. SETTING: Medical or surgical ICUs in a single tertiary care center. PATIENTS: Older than 18 years, resuscitated following either in-hospital or out-of-hospital cardiac arrest and considered for targeted temperature management between 2007 and 2013...
November 10, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29135501/temperature-variability-in-a-modern-targeted-temperature-management-trial
#3
Ahmad Abu-Arafeh, Aryelly Rodriguez, Ross L Paterson, Peter J D Andrews
OBJECTIVES: The Eurotherm3235 trial showed that therapeutic hypothermia was deleterious in patients with raised intracranial pressure following traumatic brain injury. We sought to ascertain if increased temperature variability within the first 48 hours, or for 7 days post randomization, were modifiable risk factors associated with poorer outcome. DESIGN: Eurotherm3235 was a multicenter randomized controlled trial. Patients were randomized to receive either therapeutic hypothermia in addition to standard care or the later only...
November 10, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29126457/chest-compression-related-fatal-internal-mammary-artery-injuries-manifesting-after-venoarterial-extracorporeal-membrane-oxygenation-a-case-series
#4
Toshinobu Yamagishi, Masahiro Kashiura, Kazuhiro Sugiyama, Kazuha Nakamura, Takuto Ishida, Takahiro Yukawa, Kazuki Miyazaki, Takahiro Tanabe, Yuichi Hamabe
BACKGROUND: Cardiopulmonary resuscitation-related bleeding, especially internal mammary artery injuries, can become life-threatening complications after initiating venoarterial extracorporeal membrane oxygenation owing to the frequent involvement of concomitant anticoagulant treatment, antiplatelet treatment, targeted temperature management, and bleeding coagulopathy. We report the cases of five patients who experienced this complication and discuss their management. CASE PRESENTATION: We retrospectively evaluated five patients with cardiopulmonary resuscitation-related internal mammary artery injuries who were treated between February 2011 and February 2016 at our institution...
November 11, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29113835/a-novel-approach-of-solid-waste-management-via-aromatization-using-multiphase-catalytic-pyrolysis-of-waste-polyethylene
#5
Pramendra Gaurh, Hiralal Pramanik
A new and innovative approach was adopted to increase the yield of aromatics like, benzene, toluene and xylene (BTX) in the catalytic pyrolysis of waste polyethylene (PE). The BTX content was significantly increased due to effective interaction between catalystZSM-5 and target molecules i.e., lower paraffins within the reactor. The thermal and catalytic pyrolysis both were performed in a specially designed semi-batch reactor at the temperature range of 500 °C-800 °C. Catalytic pyrolysis were performed in three different phases within the reactor batch by batch systematically, keeping the catalyst in A type- vapor phase, B type- liquid phase and C type- vapor and liquid phase (multiphase), respectively...
November 4, 2017: Waste Management
https://www.readbyqxmd.com/read/29103726/effect-of-post-pasteurization-contamination-on-fluid-milk-quality
#6
Nicole H Martin, Kathryn J Boor, Martin Wiedmann
Fluid milk quality in the United States has improved steadily over the last 2 decades, in large part due to the reduction in post-pasteurization contamination (PPC). Despite these improvements, some studies suggest that almost 50% of fluid milk still shows evidence of PPC with organisms that are able to grow at 6°C, even though PPC may be much less frequent in some facilities. Several gram-negative bacteria, when introduced as PPC, can grow rapidly at refrigeration temperatures around 6°C and can lead to bacterial levels above 20,000 cfu/mL (the regulatory limit for bacterial numbers in fluid milk in the United States) and spoilage that can be detected sensorially within 7 to 10 d of processing...
November 2, 2017: Journal of Dairy Science
https://www.readbyqxmd.com/read/29100217/nontraumatic-emergency-laparotomy-surgical-principles-similar-to-trauma-need-to-be-adopted
#7
Deepak Singh-Ranger, Edmund Leung, Mei-Ling Lau-Robinson, Sean Ramcharan, James Francombe
OBJECTIVES: In 2011, the Royal College of Surgeons published Emergency Surgery: Standards for Unscheduled Care in response to variable clinical outcomes for emergency surgery. The purpose of this study was to examine whether different treatment modalities would alter survival. METHODS: All patients who underwent emergency laparotomy between April 2011 and December 2012 at Warwick Hospital (Warwick, UK) were included retrospectively. Information relating to their demographics; preoperative score; primary pathology; timing of surgery; intraoperative details; and postoperative outcome, including 30-day mortality, were collated for statistical analysis...
November 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/29096675/the-impact-of-sex-and-age-on-neurological-outcomes-in-out-of-hospital-cardiac-arrest-patients-with-targeted-temperature-management
#8
Sang Hoon Oh, Kyu Nam Park, Jeeyong Lim, Seung Pill Choi, Joo Suk Oh, In Soo Cho, Byung Kook Lee, Yong Hwan Kim, Young-Min Kim, Han Joon Kim, Chun Song Youn, Soo Hyun Kim
BACKGROUND: There are conflicting data regarding sex-based differences in the outcomes of out-of-hospital cardiac arrest (OHCA) patients, and whether the specific sex advantage is age-specific remains unclear. We assessed the impact of the interactions between sex and age on the neurological outcomes of OHCA patients receiving targeted temperature management (TTM). METHODS: Data collected from 2007 to 2012 for a multicenter, registry-based study of the Korean Hypothermia Network were analyzed...
November 2, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29079511/lessons-from-a-pragmatic-trial-of-field-targeted-temperature-management
#9
EDITORIAL
David C Cone
No abstract text is available yet for this article.
October 24, 2017: Resuscitation
https://www.readbyqxmd.com/read/29079085/spatially-explicit-risk-approach-for-multi-hazard-assessment-and-management-in-marine-environment-the-case-study-of-the-adriatic-sea
#10
Elisa Furlan, Silvia Torresan, Andrea Critto, Antonio Marcomini
In the last few decades the health of marine ecosystems has been progressively endangered by the anthropogenic presence. Natural and human-made pressures, as well as climate change effects, are posing increasing threats on marine areas, triggering alteration of biological, chemical and physical processes. Planning of marine areas has become a challenge for decision makers involved in the design of sustainable management options. In order to address threats posed by climate drivers in combination with local to regional anthropogenic pressures affecting marine ecosystems and activities, a multi-hazard assessment methodology was developed and applied to the Adriatic Sea for the reference scenario 2000-2015...
October 24, 2017: Science of the Total Environment
https://www.readbyqxmd.com/read/29058596/efficacy-of-inhaled-hydrogen-on-neurological-outcome-following-brain-ischemia-during-post-cardiac-arrest-care-hybrid-ii-trial-study-protocol-for-a-randomized-controlled-trial
#11
Tomoyoshi Tamura, Kei Hayashida, Motoaki Sano, Shuko Onuki, Masaru Suzuki
BACKGROUND: Hydrogen gas inhalation (HI) improved survival and neurological outcomes in an animal model of post-cardiac arrest syndrome (PCAS). The feasibility and safety of HI for patients with PCAS was confirmed in a pilot study. The objective of this study is to evaluate the efficacy of HI for patients with PCAS. METHODS/DESIGN: The efficacy of inhaled HYdrogen on neurological outcome following BRain Ischemia During post-cardiac arrest care (HYBRID II) trial is an investigator-initiated, randomized, double-blind, placebo-controlled trial designed to enroll 360 adult comatose (Glasgow Coma Scale score < 8) patients who will be resuscitated following an out-of-hospital cardiac arrest of a presumed cardiac cause...
October 23, 2017: Trials
https://www.readbyqxmd.com/read/29044134/impact-of-ocean-warming-on-sustainable-fisheries-management-informs-the-ecosystem-approach-to-fisheries
#12
N Serpetti, A R Baudron, M T Burrows, B L Payne, P Helaouët, P G Fernandes, J J Heymans
An integrated ecosystem model including fishing and the impact of rising temperatures, relative to species' thermal ranges, was used to assess the cumulative effect of future climate change and sustainable levels of fishing pressure on selected target species. Historically, important stocks of cod and whiting showed declining trends caused by high fisheries exploitation and strong top-down control by their main predators (grey seals and saithe). In a no-change climate scenario these stocks recovered under sustainable management scenarios due to the cumulative effect of reduced fishing and predation mortalities cascading through the food-web...
October 18, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29039206/oxidative-stress-in-ischemia-and-reperfusion-current-concepts-novel-ideas-and-future-perspectives
#13
Christoph Sinning, Dirk Westermann, Peter Clemmensen
Oxidative stress remains a major contributor to myocardial injury after ischemia followed by reperfusion (I/R) as the reperfusion of the myocardial infarction (MI) area inevitably leads to a cascade of I/R injury. This review focused on concepts of the antioxidative defense system and elucidates recent research using antioxidants like vitamin C, E and β-carotene or essential trace elements to activate compounds of antioxidative pathways in the circulation. In this context, important defense mechanisms like superoxide dismutase and glutathione peroxidase will be described...
October 17, 2017: Biomarkers in Medicine
https://www.readbyqxmd.com/read/29038971/the-implementation-of-targeted-temperature-management-an-evidence-based-guideline-from-the-neurocritical-care-society
#14
Lori Kennedy Madden, Michelle Hill, Teresa L May, Theresa Human, Mary McKenna Guanci, Judith Jacobi, Melissa V Moreda, Neeraj Badjatia
BACKGROUND: Targeted temperature management (TTM) is often used in neurocritical care to minimize secondary neurologic injury and improve outcomes. TTM encompasses therapeutic hypothermia, controlled normothermia, and treatment of fever. TTM is best supported by evidence from neonatal hypoxic-ischemic encephalopathy and out-of-hospital cardiac arrest, although it has also been explored in ischemic stroke, traumatic brain injury, and intracranial hemorrhage patients. Critical care clinicians using TTM must select appropriate cooling techniques, provide a reasonable rate of cooling, manage shivering, and ensure adequate patient monitoring among other challenges...
October 16, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/29033104/progesterone-releasing-devices-for-cattle-estrus-induction-and-synchronization-device-optimization-to-anticipate-shorter-treatment-durations-and-new-device-developments
#15
W de Graaff, B Grimard
Synchronization programs using progesterone-releasing intravaginal devices that allow for fixed time artificial insemination are still finding increasing application in bovine reproduction. This practice is useful for rationalizing livestock management because an increased number of cows can be inseminated in one session without the need for estrus detection. Although much of the innovation related to the design and development of intravaginal devices for use in cattle took place in the previous century, progress in understanding the physiology of the bovine estrous cycle resulted in shorter treatment durations, a trend which is still continuing...
September 27, 2017: Theriogenology
https://www.readbyqxmd.com/read/29020513/application-of-an-integrated-wrf-calpuff-modeling-tool-for-source-apportionment-of-atmospheric-pollutants-for-air-quality-management-a-case-study-in-the-urban-area-of-benxi-china
#16
Hao Wu, Yan Zhang, Qi Yu, Weichun Ma
In this study, we endeavored to develop an effective framework for improving local urban air quality on meso-micro scales in cities in China that are experiencing rapid urbanization. Within this framework, the integrated WRF/CALPUFF modeling system was applied to simulate the concentration distributions of typical pollutants (PM10, SO2 and NOx) in the urban area of Benxi. Statistical analyses were performed to verify the credibility of this simulation, including the meteorological fields and concentration fields...
October 11, 2017: Journal of the Air & Waste Management Association
https://www.readbyqxmd.com/read/29017648/-neurological-prognostic-value-of-gray-white-matter-ratio-in-patients-after-respiratory-and-cardiac-arrest
#17
Hengjun Liu, Peng Xu, Fei He, Yao Liu, Jun Wang
OBJECTIVE: To evaluate the role of gray-white-matter ratio (GWR) on neurological outcome in patients with coma after cardiopulmonary resuscitation (CPR) post-respiratory and cardiac arrest (CA). METHODS: Respiratory and CA patients with restoration of spontaneous circulation (ROSC) and coma after CPR admitted to Nanjing Drum Tower Hospital Clinical Medical College of Nanjing Medical University from February 2013 to June 2016 were enrolled. All patients were subjected to target temperature management (TTM) after CPR, and received cranial CT within 5 days after ROSC...
October 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28989766/larval-abundances-of-rockfishes-that-were-historically-targeted-by-fishing-increased-over-16-years-in-association-with-a-large-marine-protected-area
#18
Andrew R Thompson, Dustin C Chen, Lian W Guo, John R Hyde, William Watson
Marine protected areas (MPAs) can facilitate recovery of diminished stocks by protecting reproductive adults. To effectively augment fisheries, however, reproductive output must increase within the bounds of MPAs so that larvae can be exported to surrounding areas and seed the region. In response to dramatic declines of rockfishes (Sebastes spp.) in southern California by the late 1990s two large MPAs, the Cowcod Conservation Areas (CCAs), were established in 2001. To evaluate whether the CCAs affected rockfish productivity we evaluated the dynamics of 8 species that were, and 7 that were not, historically targeted by fishing...
September 2017: Royal Society Open Science
https://www.readbyqxmd.com/read/28988962/prehospital-cooling-to-improve-successful-targeted-temperature-management-after-cardiac-arrest-a-randomized-controlled-trial
#19
D C Scales, S Cheskes, P R Verbeek, R Pinto, D Austin, S C Brooks, K N Dainty, K Goncharenko, M Mamdani, K E Thorpe, L J Morrison
RATIONALE: Targeted temperature management (TTM) improves survival with good neurological outcome after out-of-hospital cardiac arrest (OHCA), but is delivered inconsistently and often with delay. OBJECTIVE: To determine if prehospital cooling by paramedics leads to higher rates of 'successful TTM', defined as achieving a target temperature of 32-34°C within 6h of hospital arrival. METHODS: Pragmatic RCT comparing prehospital cooling (surface ice packs, cold saline infusion, wristband reminders) initiated 5min after return of spontaneous circulation (ROSC) versus usual resuscitation and transport...
October 5, 2017: Resuscitation
https://www.readbyqxmd.com/read/28981963/serum-tau-and-neurological-outcome-in-cardiac-arrest
#20
Niklas Mattsson, Henrik Zetterberg, Niklas Nielsen, Kaj Blennow, Josef Dankiewicz, Hans Friberg, Gisela Lilja, Philip S Insel, Christian Rylander, Pascal Stammet, Anders Aneman, Christian Hassager, Jesper Kjaergaard, Michael Kuiper, Tommaso Pellis, Jørn Wetterslev, Matthew Wise, Tobias Cronberg
OBJECTIVE: To test serum tau as a predictor of neurological outcome after cardiac arrest. METHODS: We measured the neuronal protein tau in serum at 24, 48, and 72 h after cardiac arrest in 689 patients in the prospective international Target Temperature Management trial. The main outcome was poor neurological outcome, defined as Cerebral Performance Category 3-5 at 6 months. RESULTS: Increased tau was associated with poor outcome at 6 months after cardiac arrest (median 38...
October 5, 2017: Annals of Neurology
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