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https://www.readbyqxmd.com/read/28818494/gts-21-reduces-microvascular-permeability-during-experimental-endotoxemia
#1
Karsten Schmidt, Sukanya Bhakdisongkhram, Florian Uhle, Christoph Philipsenburg, Aleksandar R Zivkovic, Thorsten Brenner, Johann Motsch, Markus A Weigand, Stefan Hofer
INTRODUCTION: No effective pharmacological therapy is currently available to attenuate tissue edema formation due to increased microvascular permeability in sepsis. Cholinergic mediators have been demonstrated to exert anti-inflammatory effects via the α7 nicotinic acetylcholine receptor (α7nAChR) during inflammation. GTS-21, a partial α7nAChR agonist, is an appealing therapeutic substance for sepsis-induced microvascular inflammation due to its demonstrated cholinergic anti-inflammatory properties and its favorable safety profile in clinical trials...
August 14, 2017: Microvascular Research
https://www.readbyqxmd.com/read/28817996/meningioma-with-tyrosine-rich-crystalloids-a-case-report-and-review-of-the-literature
#2
Erik Reinertsen, Stewart G Neill, Kambiz Nael, Daniel J Brat, Costas G Hadjipanayis
We report a case of fibrous meningioma with tyrosine-rich crystalloid in the frontal lobe of a middle-aged woman. The patient presented with a history of several years of worsening headaches and blurry vision, which progressed to include syncopal episodes and right-sided weakness. Imaging demonstrated a dural-based extra-axial mass arising from the right orbital roof and extending superiorly along the right frontal convexity causing right-to-left midline shift. The patient underwent a craniotomy and operative resection...
August 1, 2017: International Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28814247/fluid-and-medication-considerations-in-the-traumatized-patient
#3
Amita Misir
This article reviews fluid therapy and medications in pediatric trauma. For resuscitation in the setting of hemorrhagic shock, isotonic crystalloid solution is the first-line agent of choice. Colloid solutions offer no additional benefit, introduce possible increased risks and cost more than crystalloids. Blood products, starting with pRBCs, should be introduced after 20-40 ml/kg of crystalloid has been administered if there is ongoing need for volume replacement. The use of a massive transfusion protocol of 1:1:1 (if >30 kg) or 30:20:20 (if <30 kg) of pRBCs:FFP:platelets is suggested after an initial 30 ml/kg of pRBcs have been administered...
August 14, 2017: Current Pediatric Reviews
https://www.readbyqxmd.com/read/28809612/a-retrospective-study-evaluating-the-efficacy-of-identification-and-management-of-sepsis-at-a-district-level-hospital-internal-medicine-department-in-the-western-cape-province-south-africa-in-comparison-with-the-guidelines-stipulated-in-the-2012-survivi
#4
Raisa Bhikoo, Sarah Versfeld, M M De V Basson, Almero H Oosthuizen
BACKGROUND: Currently there is little information on the identification, management and outcomes of patients with sepsis in developing countries. Simple cost-effective measures such as accurate identification of patients with sepsis and early antibiotic administration are achievable targets, within reach without having to make use of unsustainable protocols constructed in developed countries. OBJECTIVES: To assess the ability of clinicians at a district-level hospital to identify and manage sepsis, and to assess patient outcome in terms of in-hospital mortality and length of hospital stay given the above management...
July 28, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28799264/correlation-of-lanthanum-dosage-with-lanthanum-deposition-in-the-gastroduodenal-mucosa-of-dialysis-patients
#5
Kimiaki Hattori, Tamaki Maeda, Shinya Nishida, Miyuki Imanishi, Masahiro Sakaguchi, Yoshifumi Amari, Takuya Moriya, Yoshinobu Hirose
Lanthanum (La) deposition has been observed in gastrointestinal mucosa of dialysis patients treated with La carbonate to treat hyperphosphatemia in the 6 years since its authorization in Japan. We investigated gastrointestinal biopsies from 112 dialysis patients, and found 15 cases of histiocytic aggregation with crystalloids and one case of duodenitis with histiocyte aggregation without crystalloids in the 30 patients treated with La carbonate. No histiocytic lesions were observed in the 82 patients without La carbonate administration...
August 11, 2017: Pathology International
https://www.readbyqxmd.com/read/28782112/lower-vs-higher-fluid-volumes-in-sepsis-protocol-for-a-systematic-review-with-meta-analysis
#6
T S Meyhoff, M H Møller, P B Hjortrup, M Cronhjort, A Perner, J Wetterslev
BACKGROUND: Intravenous fluid administration with crystalloids is recommended in the initial management of sepsis. However, the quality of evidence supporting the recommendation on fluid volumes is low, and clinical equipoise exists. Potential benefits of restricting fluid volumes has been suggested, but the overall benefit or harm in patients with sepsis is unknown. Accordingly, we aim to assess patient-important benefits and harms of lower vs. higher fluid volumes in resuscitation of adult patients with sepsis...
September 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28780148/intra-abdominal-hypertension-abdominal-compartment-syndrome-and-the-open-abdomen
#7
REVIEW
William Kirke Rogers, Luis Garcia
Abdominal Compartment Syndrome (ACS) is the endpoint of a process whereby massive interstitial swelling in the abdomen or rapid development of a space-filling lesion within the abdomen (such as ascites or a hematoma) leads to a pathologically increased pressure. This results in so-called Intra-Abdominal Hypertension (IAH), causing decreased perfusion of the kidneys and abdominal viscera and possible difficulties with ventilation and maintenance of cardiac output. These effects contribute to a cascade of ischemia and multiple organ dysfunction with high mortality...
August 2, 2017: Chest
https://www.readbyqxmd.com/read/28774642/effect-of-0-9-saline-or-plasma-lyte-148-as-crystalloid-fluid-therapy-in-the-intensive-care-unit-on-blood-product-use-and-postoperative-bleeding-after-cardiac-surgery
#8
Sumeet K Reddy, Michael J Bailey, Richard W Beasley, Rinaldo Bellomo, Diane M Mackle, Alex J Psirides, Paul J Young
OBJECTIVE: To evaluate the effect of Plasma-Lyte 148 (PL-148) compared with 0.9% saline (saline) on blood product use and postoperative bleeding in patients admitted to the intensive care unit (ICU) following cardiac surgery. DESIGN: A post hoc subgroup analysis conducted within a multicenter, double-blind, cluster-randomized, double-crossover study (study 1) and a prospective, single-center nested-cohort study (study 2). SETTING: Tertiary-care hospitals...
April 15, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28774488/crystalloid-versus-colloid-fluids-for-reduction-of-postoperative-ileus-after-abdominal-operation-under-combined-general-and-epidural-anesthesia
#9
Mohammad Reza Ghodraty, Faranak Rokhtabnak, Hossein Reza Dehghan, Alireza Pournajafian, Masoud Baghaee Vaji, Zahra Sadat Koleini, Jahan Porhomayon, Nader D Nader
BACKGROUND: The main objective of this study was to compare the effect of perioperative administration of crystalloid versus colloid solutions and its impact on reversal of ileus after resection with primary anastomosis of intestine. We hypothesized that inclusion of colloids will improve the return of intestinal motility. METHODS: In a double-blinded clinical trial, 91 the American Society of Anesthesiologists I to III patients undergoing abdominal operation for resection with anastomosis of small or large intestine were randomized to receive either lactated Ringer solution crystalloid group or 6% hydroxyethyl starch colloid group to replace intraoperative fluid loss (blood loss + third space)...
July 31, 2017: Surgery
https://www.readbyqxmd.com/read/28770202/cysteinyl-leukotrienes-in-eosinophil-biology-functional-roles-and-therapeutic-perspectives-in-eosinophilic-disorders
#10
REVIEW
Glaucia A Thompson-Souza, Isabella Gropillo, Josiane S Neves
Cysteinyl leukotrienes (cysLTs), LTC4, and its extracellular metabolites, LTD4 and LTE4, have varied and multiple roles in mediating eosinophilic disorders including host defense against parasitic helminthes and allergic inflammation, especially in the lung and in asthma. CysLTs are known to act through at least 2 receptors termed cysLT1 receptor (CysLT1R) and cysLT2 receptor (CysLT2R). Eosinophils contain a dominant population of cytoplasmic crystalloid granules that store various preformed proteins. Human eosinophils are sources of cysLTs and are known to express the two known cysLTs receptors (CysLTRs)...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28768527/bilateral-blindness-secondary-to-optic-nerve-ischemia-from-severe-amlodipine-overdose-a-case-report
#11
Raymond Kao, Yves Landry, Genevieve Chick, Andrew Leung
BACKGROUND: Calcium channel blockers are commonly prescribed medications; calcium channel blocker overdose is becoming increasingly prevalent. The typical presentation of a calcium channel blocker overdose is hypotension and decreased level of consciousness. We describe a case of a calcium channel blocker overdose that led to bilateral cortical blindness, a presentation that has not previously been reported. CASE PRESENTATION: A 49-year-old white woman with known bilateral early optic atrophy presented to our hospital with hypotension and obtundation following a known ingestion of 150 mg of amlodipine...
August 3, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28765353/hemostatic-management-of-trauma-induced-coagulopathy
#12
Janise B Phillips, Phillip L Mohorn, Rebecca E Bookstaver, Tanya O Ezekiel, Christopher M Watson
Trauma-induced coagulopathy is a primary factor in many trauma-related fatalities. Management hinges upon rapid diagnosis of coagulation abnormalities and immediate administration of appropriate hemostatic agents. Use of crystalloids and packed red blood cells has traditionally been the core of trauma resuscitation, but current massive transfusion protocols include combination therapy with fresh frozen plasma and predefined ratios of platelets to packed red blood cells, limiting crystalloid administration. Hemostatic agents such as tranexamic acid, prothrombin complex concentrate, fibrinogen concentrate, and, in cases of refractory bleeding, recombinant activated factor VIIa may also be warranted...
August 2017: Critical Care Nurse
https://www.readbyqxmd.com/read/28762023/efficacy-of-goal-directed-fluid-therapy-via-pleth-variability-index-during-laparoscopic-roux-en-y-gastric-bypass-surgery-in-morbidly-obese-patients
#13
İsmail Demirel, Esef Bolat, Aysun Yıldız Altun, Mustafa Özdemir, Azize Beştaş
BACKGROUND: There is no well-recognized guideline for intraoperative fluid management in bariatric surgery. Goal-directed fluid therapy (GDFT) is a new concept of perioperative fluid management which was shown to improve patients' prognoses. Dynamic indicators may better predict fluid response compared to static indicators. In this study, we aimed to assess effects of administering GDFT protocol via Pleth Variability Index (PVI) in morbidly obese patients undergoing laparoscopic Roux-en-Y gastric bypass (RYGB) surgery...
July 31, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28759487/aortocaval-compression-syndrome-time-to-revisit-certain-dogmas
#14
Allison J Lee, Ruth Landau
More than 70 years ago, the phenomenon of "postural shock" in the supine position was described in healthy women in late pregnancy. Since then, avoidance of the supine position has become a key component of clinical practice. Indeed, performing pelvic tilt in mothers at term to avoid aortocaval compression is a universally adopted measure, particularly during cesarean delivery. The studies on which this practice is based are largely nonrandomized, utilized a mix of anesthetic techniques, and were conducted decades ago in the setting of avoidance of vasopressors...
July 27, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28757925/passive-leg-raising-simple-and-reliable-technique-to-prevent-fluid-overload-in-critically-ill-patients
#15
Farahnak Assadi
BACKGROUND: Dynamic measures, the response to stroke volume (SV) to fluid loading, have been used successfully to guide fluid management decisions in critically ill patients. However, application of dynamic measures is often inaccurate to predict fluid responsiveness in patients with arrhythmias, ventricular dysfunction or spontaneously breathing critically ill patients. Passive leg raising (PLR) is a simple bedside maneuver that may provide an accurate alternative to guide fluid resuscitation in hypovolemic critically ill patients...
2017: International Journal of Preventive Medicine
https://www.readbyqxmd.com/read/28748114/uric-acid-in-plants-and-microorganisms-biological-applications-and-genetics-a-review
#16
REVIEW
Rehab M Hafez, Tahany M Abdel-Rahman, Rasha M Naguib
Uric acid increased accumulation and/or reduced excretion in human bodies is closely related to pathogenesis of gout and hyperuricemia. It is highly affected by the high intake of food rich in purine. Uric acid is present in both higher plants and microorganisms with species dependent concentration. Urate-degrading enzymes are found both in plants and microorganisms but the mechanisms by which plant degrade uric acid was found to be different among them. Higher plants produce various metabolites which could inhibit xanthine oxidase and xanthine oxidoreductase, so prohibit the oxidation of hypoxanthine to xanthine then to uric acid in the purine metabolism...
September 2017: Journal of Advanced Research
https://www.readbyqxmd.com/read/28746899/hypertonic-saline-in-critical-illness-a-systematic-review
#17
REVIEW
Carmen Andrea Pfortmueller, Joerg C Schefold
INTRODUCTION: The optimal approach to fluid management in critically ill patients is highly debated. Fluid resuscitation using hypertonic saline was used in the past for more than thirty years, but has recently disappeared from clinical practice. Here we provide an overview on the currently available literature on effects of hypertonic saline infusion for fluid resuscitation in the critically ill. METHODS: Systematic analysis of reports of clinical trials comparing effects of hypertonic saline as resuscitation fluid to other available crystalloid solutions...
June 19, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28742442/analysis-of-variability-in-intraoperative-fluid-administration-for-colorectal-surgery-an-argument-for-goal-directed-fluid-therapy
#18
Timothy D Quinn, Ethan Y Brovman, Richard D Urman
BACKGROUND: Fluid therapy in the perioperative period varies greatly between anesthesia providers and may have a negative impact on surgical outcomes. METHODS: We conducted a retrospective analysis of 705 elective colorectal cases consisting of colectomies, ileocolic resections, and low anterior resections at an academic institution from January 1, 2010 to May 29, 2015, collected by our electronic medical record before implementation of Enhanced Recovery After Surgery (ERAS(®)) pathways...
July 25, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28742231/different-resuscitation-strategies-and-novel-pharmacologic-treatment-with-valproic-acid-in-traumatic-brain-injury
#19
REVIEW
Simone E Dekker, Vahagn C Nikolian, Martin Sillesen, Ted Bambakidis, Patrick Schober, Hasan B Alam
Traumatic brain injury (TBI) is a leading cause of death in young adults, and effective treatment strategies have the potential to save many lives. TBI results in coagulopathy, endothelial dysfunction, inflammation, cell death, and impaired epigenetic homeostasis, ultimately leading to morbidity and/or mortality. Commonly used resuscitation fluids such as crystalloids or colloids have several disadvantages and might even be harmful when administered in large quantities. There is a need for next-generation treatment strategies (especially in the prehospital setting) that minimize cellular damage, improve survival, and enhance neurological recovery...
July 25, 2017: Journal of Neuroscience Research
https://www.readbyqxmd.com/read/28737073/bleeding-pelvic-fracture-patients-evolution-of-resuscitation-protocols
#20
T Söderlund, T Ketonen, L Handolin
BACKGROUND AND AIMS: Massive transfusion protocol seems to improve outcome in massively bleeding trauma patients, but not pelvic fracture patients. The aim of this study was to evaluate the effect of massive transfusion protocol on the mortality and fluid resuscitation of shocked pelvic fracture patients. MATERIAL AND METHODS: This is a trauma register study from a single hospital. From the trauma registry patients with pelvic fracture, injury severity score >15, admission base excess below -5, age >15 years, blunt trauma, and primary admission from the scene were identified...
March 1, 2017: Scandinavian Journal of Surgery: SJS
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