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https://www.readbyqxmd.com/read/29670382/clinical-outcomes-and-health-care-utilization-pre-and-post-laparoscopic-radiofrequency-ablation-of-symptomatic-fibroids-and-laparoscopic-myomectomy-a-randomized-trial-of-uterine-sparing-techniques-trust-in-canada
#1
Darrien D Rattray, Laura Weins, Lexy C Regush, James M Bowen, Daria O'Reilly, John A Thiel
Objective: The objective of this study was to compare laparoscopic ultrasound-guided radiofrequency ablation of fibroids (Lap-RFA) and laparoscopic myomectomy in terms of 1) health care utilization and 2) serious complication rates. The secondary objectives were comparison of subject responses to validated symptom and quality-of-life questionnaires. We hypothesized that Lap-RFA health care utilization and clinical outcomes would not be worse than those of laparoscopic myomectomy in the aggregate...
2018: ClinicoEconomics and Outcomes Research: CEOR
https://www.readbyqxmd.com/read/29659376/when-a-child-dies-unexpectedly-no-truth-be-told
#2
Deborah L Callanan, William D McClain
Sudden death of a child beyond infancy is a rare event. We report a child who presented to the emergency care system with asystole and the caregiver's report of an asthma attack as the preceding event. After unsuccessful attempts at resuscitation, an autopsy was performed by the medical examiner. Despite only scattered bruises with no clear-cut signs of abuse, aortic rupture and spinal fractures were found. This case highlights the crucial role of the medical examiner in evaluating sudden childhood death, even in the setting of underlying illness...
April 13, 2018: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/29644580/on-the-efficacy-of-cardio-pulmonary-resuscitation-and-epinephrine-following-cyanide-and-h-2-s-intoxication-induced-cardiac-asystole
#3
Annick Judenherc-HaouzI, Takashi Sonobe, Vikhyat S Bebarta, Philippe Haouzi
This study was aimed at determining the efficacy of epinephrine, followed by chest compressions, in producing a return of spontaneous circulation (ROSC) during cyanide (CN)- or hydrogen sulfide (H2 S)-induced toxic cardiac pulseless electrical activity (PEA) in the rat. Thirty-nine anesthetized rats were exposed to either intravenous KCN (n = 27) or H2 S solutions (n = 12), at a rate that led to a PEA within less than 10 min. In the group intoxicated by CN, 20 rats were mechanically ventilated and received either epinephrine (0...
April 11, 2018: Cardiovascular Toxicology
https://www.readbyqxmd.com/read/29627435/ventricular-arrhythmias-and-sudden-cardiac-arrest-in-takotsubo-cardiomyopathy-incidence-predictive-factors-and-clinical-implications
#4
Laurence Jesel, Charlotte Berthon, Nathan Messas, Han S Lim, Mélanie Girardey, Halim Marzak, Benjamin Marchandot, Annie Trinh, Patrick Ohlmann, Olivier Morel
BACKGROUND: Takotsubo cardiomyopathy (TTC) is a stress-related transient cardiomyopathy. Life threatening arrhythmias (LTA) can occur and worsen prognosis. OBJECTIVE: The purpose of this study was to assess the incidence and outcome of LTA in TTC, its predictive factors and clinical implications. METHODS: We studied 214 consecutive cases of TTC over 8 years. The study cohort was divided into two groups - those with LTA (LTA-group) and those without (non-LTA-group)...
April 5, 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/29604136/discontinued-stimulation-of-cardiomyocytes-provides-protection-against-hypothermia-rewarming-induced-disruption-of-excitation-contraction-coupling
#5
Young Soo Han, Niccole Schaible, Torkjel Tveita, Gary Sieck
After exposing spontaneously beating hearts as well as electrically stimulated isolated cardiomyocytes to hypothermia/rewarming (H/R), cardiac dysfunction or alterations in excitation-contraction coupling, respectively, is a consequence. In contrast, hypothermic cardiac arrest as routinely applied during cardiac surgery, will not impose any hazard to cardiac function after rewarming. We hypothesize that by maintaining asystole during H/R, cardiomyocytes will avoid Ca2+ overload due to the transient stimulation-evoked elevation of [Ca2+ ]cyto and thus, H/R-induced elevation of p-cTnI, and reduced Ca2+ sensitivity after rewarming...
March 31, 2018: Experimental Physiology
https://www.readbyqxmd.com/read/29593417/long-term-outcomes-and-predictors-of-survival-after-cardiopulmonary-resuscitation-for-in-hospital-cardiac-arrest-in-a-tertiary-care-hospital-in-thailand
#6
Panita Limpawattana, Wannaporn Aungsakul, Chomchanok Suraditnan, Anupol Panitchote, Boonsong Patjanasoontorn, Anakapong Phunmanee, Nittaya Pittayawattanachai
Background: There are limited data available regarding long-term survival and its predictors in cases of in-hospital cardiac arrest (IHCA) in which patients receive cardiopulmonary resuscitation. Purpose: The objectives of this study were to determine the 1-year survival rates and predictors of survival after IHCA. Patients and methods: Data were retrospectively collected on all adult patients who were administered cardiopulmonary resuscitation from January 1, 2013 to December 31, 2014 in Srinagarind Hospital (Thailand)...
2018: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/29579853/survival-and-evolution-of-renal-function-in-kidney-transplant-recipients-from-type-ii-asystolic-donations-a-single-center-experience
#7
N G Toapanta Gaibor, F M González-Roncero, M Cintra Cabrera, M Suñer Poblet, G Bernal Blanco, A Suarez Benjumea, M A Pérez-Valdivia, J J Egea-Guerrero, J L Rocha Castilla, M A Gentil Govantes
BACKGROUND: In recent years, stagnation in the number of kidneys from after brain-dead donors (DBD) has stimulated the use of non-heart beating donors (NHBDs). Herein we present our 5-year experience with type II Maastricht NHBDs in renal transplantation. METHODS: All patients (n = 50) in this study received type II Maastricht NHBD kidneys (March 2012 to February 2017), with a median follow-up of 33 months. RESULTS: Mean donor age was 39 ± 12 years, mean creatinine 1...
March 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29573754/beyond-the-limits-ecpr-in-putative-fatal-circumstances
#8
Ingo Graeff, Sylvia Schacher, Stefan Lenkeit, Catherine N Widmann, Jens-Christian Schewe
The eligibility criteria for applying extracorporeal cardiopulmonary resuscitation (ECPR) in patients with cardiac arrest are currently unclear. For those patients with hypothermic cardiac arrest, the European Resuscitation Council (ERC) Guidelines recommend considering ECPR only for patients with potassium <8 mmol/L and a body temperature below 32°C, whereas the American Heart Association Guidelines (AHA) do not express this in a specific manner. We report the case of an urban unwitnessed out-of-hospital cardiac arrest patient found with her head immersed in water at a temperature of 23°C...
March 25, 2018: CJEM
https://www.readbyqxmd.com/read/29561649/magnesium-sulfate-and-sex-differences-in-cardiovascular-and-neural-adaptations-during-normoxia-and-asphyxia-in-preterm-fetal-sheep
#9
Robert Galinsky, Simerdeep K Dhillon, Christopher A Lear, Kyohei Yamaguchi, Guido Wassink, Alistair J Gunn, Laura Bennet
Magnesium sulfate (MgSO4 ) is recommended for preterm neuroprotection, preeclampsia and preterm labor prophylaxis. There is an important unmet need to carefully test clinical interventions in both sexes. Therefore, we aimed to investigate cardiovascular and neurophysiological adaptations to MgSO4 during normoxia and asphyxia in preterm male and female fetal sheep. Fetuses were instrumented at 98{plus minus}1 days of gestation (d; term=147 d). At 104 d, unanaesthetised fetuses were randomly assigned to intravenous MgSO4 (n=12 F, 10 M) or saline (n=13 F, 10 M)...
March 21, 2018: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
https://www.readbyqxmd.com/read/29549524/evaluation-of-the-effectiveness-of-sugammadex-for-digoxin-intoxication-an-experimental-study
#10
Sule Ozbilgin, Derya Aslan Yurtlu, Beyza Küçükoztaş, Gonca Kamacı, Sezen Korkut, Bülent Serhan Yurtlu, M Ensari Güneli, Volkan Hancı, Ali Günerli
Previous studies have shown that cyclodextrin group medicines bind to various drugs. The hypothesis of our study is to determine whether sugammadex could bind to digoxin and delay the cardiovascular toxicity of that drug. Twenty-eight sedated Wistar rats were infused with digoxin at 3 mg/h (0.25 mg/ml). Five minutes after the start of infusion, animals were treated with a bolus of either 16 mg/kg (Sgdx16), 100 mg/kg (Sgdx100), or 1000 mg/kg (Sgdx1000) sugammadex. The control group infusion did not contain sugammadex...
March 16, 2018: Cardiovascular Toxicology
https://www.readbyqxmd.com/read/29549227/differentiating-motor-phenomena-in-tilt-induced-syncope-and-convulsive-seizures
#11
Sharon Shmuely, Prisca R Bauer, Erik W van Zwet, J Gert van Dijk, Roland D Thijs
OBJECTIVE: We assessed motor phenomena in syncope and convulsive seizures to aid differential diagnosis and understand the pathophysiologic correlates. METHODS: We studied video-EEG recordings of tilt-induced syncope and convulsive seizures in participants aged 15 years and older. Syncope was defined as (1) loss of consciousness (video-assessed), (2) circulatory changes (accelerating blood pressure decrease with or without bradycardia/asystole), and (3) EEG changes ("slow" or "slow-flat-slow")...
March 16, 2018: Neurology
https://www.readbyqxmd.com/read/29527908/novel-patterns-of-left-ventricular-mechanical-activity-during-experimental-cardiac-arrest-in-pigs
#12
R Skulec, D Astapenko, R Cerna Parizkova, B Furst, M Bilska, T Parizek, T Hovanec, N Pinterova, J Knor, J Dudakova, A Truhlar, V Radochova, Z Zadak, V Cerny
We conducted an experimental study to evaluate the presence of coordinated left ventricular mechanical myocardial activity (LVMA) in two types of experimentally induced cardiac arrest: ventricular fibrillation (VF) and pulseless electrical activity (PEA). Twenty anesthetized domestic pigs were randomized 1:1 either to induction of VF or PEA. They were left in nonresuscitated cardiac arrest until the cessation of LVMA and microcirculation. Surface ECG, presence of LVMA by transthoracic echocardiography and sublingual microcirculation were recorded...
March 12, 2018: Physiological Research
https://www.readbyqxmd.com/read/29521654/diltiazem-associated-cardiogenic-shock-in-thyrotoxic-crisis
#13
Ahmed Subahi, Walid Ibrahim, Ashraf Abugroun
CLINICAL FEATURES: The patient we present is a 39-year-old woman with a history of hyperthyroidism who developed fast atrial fibrillation secondary to thyrotoxic storm. After the initiation of intravenous diltiazem drip, she developed hypotension, bradycardia, then asystole cardiac arrest. THERAPEUTIC CHALLENGE: It is well known that calcium channel blockers and beta blockers should be used with extreme caution if the patient with thyroid storm has decompensated heart failure with reduced ejection fraction...
February 28, 2018: American Journal of Therapeutics
https://www.readbyqxmd.com/read/29520908/electrocardiogram-failure-in-the-operating-room-bench-testing-to-prevent-bed-side-disaster
#14
B Cowie, L Baker, B Shoghi, M Worner, D Scott
Electrocardiogram (ECG) false alarms are common in electrically-hostile peri-operative environments. Newer integrated monitoring, with sophisticated hardware and software, has the potential to minimise artefacts. However, monitoring issues continue to occur, with the potential for critical incidents and unnecessary and harmful interventions. We describe the root cause analysis of a series of apparent ECG flatline asystolic events that appeared in the operating room shortly after the introduction of new intra-operative monitoring systems...
March 9, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29520391/the-safety-of-a-mixture-of-bupivacaine-and-lidocaine-in-children-after-urologic-inguinal-and-scrotal-surgery
#15
Kyoung Lee, Jae Min Chung, Sang Don Lee
Purpose: Local anesthetic agents such as bupivacaine and lidocaine are commonly used after surgery for pain control. The aim of this prospective study was to evaluate the safety of a mixture of bupivacaine and lidocaine in children who underwent urologic inguinal and scrotal surgery. Materials and Methods: Fifty-five patients who underwent pediatric urologic outpatient surgeries, were prospectively enrolled in this study. The patients were divided into three groups according to age (group I: under 2 years, group II: between 3-4 years, and group III: 5 years and above)...
March 2018: Investigative and Clinical Urology
https://www.readbyqxmd.com/read/29486618/involvement-of-il-1%C3%AE-and-il-6-in-antiarrhythmic-properties-of-atorvastatin-in-ouabain-induced-arrhythmia-in-rats
#16
Mahya Najjari, Gholamhassan Vaezi, Vida Hojati, Zahra Mousavi, Azam Bakhtiarian, Vahid Nikoui
PURPOSE: Evidence show that statins possess wide beneficial cardioprotective and anti-inflammatory effects; therefore, in the present experiment, we investigated the antiarrhythmic properties of atorvastatin in ouabain-induced arrhythmia in isolated rat atria and the role of several inflammatory cytokines in this effect. MATERIALS AND METHODS: Male rats were pretreated with either of atorvastatin (10 mg/kg) or vehicle, orally once daily for 6 weeks. After induction of anesthesia, we isolated the atria and after incubation with ouabain, time of onset of arrhythmia and asystole as well as atrial beating rate and contractile force were recorded...
February 28, 2018: Immunopharmacology and Immunotoxicology
https://www.readbyqxmd.com/read/29485991/the-dead-and-the-dying-a-difficult-part-of-ems-transport-a-swiss-cross-sectional-study
#17
Rebecca Maria Hasler, Sandra Stucky, Heinz Bähler, Aristomenis K Exadaktylos, Frank Neff
OBJECTIVE: Most deaths occur in the pre-hospital setting, whereas mortality in the emergency department (ED) is low (<1%). However, our clinical impression is that some patients are being transported to hospital in devastating conditions with no likelihood of survival, but demanding extensive hospital resources. The decision on whether to transport a dying person to hospital or not is a difficult task for emergency medical services (EMS) personnel. As there is little epidemiological data about these patients, this paper aims to describe this special population...
2018: PloS One
https://www.readbyqxmd.com/read/29452744/emerging-concepts-in-diagnosis-and-treatment-of-syncope-by-pacing
#18
REVIEW
Richard Sutton, Jean-Claude Deharo, Michele Brignole, Mohamed H Hamdan
Neuroendocrine syncope is a newly proposed term to embody both syncope of reflex and adenosine-related etiology. Recent publications on tilt testing have revealed the presence of a hypotensive tendency in some patients, even in the face of severe cardioinhibition. This new understanding may allow better selection of older reflex syncope patients, documented by ECG loop recorder, for successful pacing where tilt testing is ideally negative for a good result in terms of few syncope recurrences and prompts a less aggressive management policy when hypotensive medication is required...
February 13, 2018: Trends in Cardiovascular Medicine
https://www.readbyqxmd.com/read/29452330/atypical-teratoid-rhabdoid-tumor-after-in-vitro-fertilization-illustrative-case-report-and-systematic-literature-review
#19
REVIEW
Adomas Bunevicius, Algimantas Matukevicius, Vytenis Deltuva, Inga Gudinaviciene, Darius Pranys, Arimantas Tamsauskas
OBJECTIVE: In vitro fertilization (IVF) is increasingly used for treatment of infertile couples worldwide. The association between IVF and cancer risk in offsprings is conflicting. We present a case of atypical teratoid/rhabdoid tumor (AT/RT) in a girl conceived by IVF and present results of systematic review of literature of primary intracranial neoplasms diagnosed in children conceived by IVF. METHODS: A systematic review of literature was conducted on April 12, 2017 to identify previously published reports of intracranial brain tumors in patients conceived after IVF...
February 13, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29445308/cpr-in-medical-tv-shows-non-health-care-student-perspective
#20
Abdullah Alismail, Nicole C Meyer, Waleed Almutairi, Noha S Daher
Introduction: There are over a dozen medical shows airing on television, many of which are during prime time. Researchers have recently become more interested in the role of these shows, and the awareness on cardiopulmonary resuscitation. Several cases have been reported where a lay person resuscitated a family member using medical TV shows as a reference. The purpose of this study is to examine and evaluate college students' perception on cardiopulmonary resuscitation and when to shock using an automated external defibrillator based on their experience of watching medical TV shows...
2018: Advances in Medical Education and Practice
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