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weaning protocol

Andressa Teles, Joan Salas-Leiva, Carlos Alfonso Alvarez-González, Dariel Tovar-Ramírez
This study contributes to basic knowledge on the development of larval digestive enzyme activities of Seriola rivoliana, a carnivorous species that has shown high mortality in larval stage. The study was conducted under laboratory-controlled conditions until larvae reached 30 days after hatching (DAH). The specific activity of amylase and pepsin was analysed by spectrophotometric methods, and lipase, trypsin, chymotrypsin and alkaline phosphatase by fluorometry. The results showed that S. rivoliana larvae had different enzyme patterns depending on their developmental stage, and also when exogenous food was administered (rotifers and Artemia)...
December 8, 2018: Fish Physiology and Biochemistry
Scott Dee, Jose Ezequiel Guzman, Dan Hanson, Noel Garbes, Robert Morrison, Deborah Amodie, Lucina Galina Pantoja
The trial objective was to compare the performance and animal health parameters of pigs raised according to one of 3 antibiotic (AB) protocols: standard AB medication consisting of mass treatment on days 4 and 21 and judicious AB therapy given therapeutically thereafter as group medication in water and feed or by individual injection (group T1, N = 702); modified AB medication identical to group T1 but with mass treatment only on day 4 and without subsequent therapeutic feed medication (group T2, N = 675); or an antibiotic-free (ABF) regimen (group T3, N = 702)...
2018: PloS One
Pedro Bichaff, Karina T Setani, Emiliana H G Motta, Artur F Delgado, Werther B Carvalho, Michele Luglio
OBJECTIVE: Opioid abstinence syndrome is common in the pediatric intensive care environment because sedation is often needed during the children's treatment. There is no specific guideline regarding the management of these patients; and lately, methadone is an important drug for the prevention of abstinence symptoms during the weaning of opioids. This study gathers the available research to establish the initial dose of methadone, the rate of taper and tools to recognize this syndrome and act promptly...
October 2018: Revista da Associação Médica Brasileira
Diana Greene-Chandos, Michel Torbey
PURPOSE OF REVIEW: Weakness is a common reason patients are seen in neurologic consultation. This article reviews the differential diagnosis of neuromuscular disorders in the intensive care unit (ICU), discusses the intensive care needs and evaluation of respiratory failure in patients with neuromuscular disorders, and provides a practical guide for management. RECENT FINDINGS: Although primary neuromuscular disorders used to be the most common cause for weakness from peripheral nervous system disease in the ICU, a shift toward ICU-acquired weakness is observed in today's clinical practice...
December 2018: Continuum: Lifelong Learning in Neurology
Timothy E Newhook, Timothy J Vreeland, Whitney L Dewhurst, Xuemei Wang, Laura Prakash, Chun Feng, Morgan L Bruno, Michael P Kim, Thomas A Aloia, Jean-Nicolas Vauthey, Jeffrey E Lee, Matthew H G Katz, Ching-Wei D Tzeng
OBJECTIVE: To characterize opioid discharge prescriptions for pancreatectomy patients. BACKGROUND: Wide variation in and over-prescription of opioids after surgery contribute to the United States opioid epidemic through persistent use past the postoperative period. Objective strategies guiding discharge opioid prescriptions for oncologic surgery are lacking, and factors driving prescription amount are not fully delineated. METHODS: Characteristics of pancreatectomy patients (March 2016-August 2017) were retrospectively abstracted from a prospective database...
November 29, 2018: Annals of Surgery
Utkarsh Kohli, Karen L Pumphrey, Aziez Ahmed, Srikant Das
A 13 kg, 20 month-old, Caucasian girl, presented with cardiomyopathy, biventricular dysfunction and pre-excitation on electrocardiogram. She had normal intracardiac anatomy with severely dilated left ventricle and severely diminished biventricular function (Fig. 1). She was treated with milrinone and epinephrine infusions, mechanical ventilation and listed for heart transplant. She underwent Berlin Heart EXCOR biventricular assist device (BiVAD) placement (30 ml LVAD and 25 ml RVAD pumps). No supraventricular tachycardia (SVT) was inducible or noted during her hospitalization...
November 2018: Journal of Electrocardiology
Abdalrhman Al Saadon, Riley Katulka, Meghan Sebastianski, Robin Featherstone, Ben Vandermeer, R T Noel Gibney, Oleksa G Rewa, Sean M Bagshaw
INTRODUCTION: Renal replacement therapy (RRT) is a complex and expensive form of life-sustaining therapy, reserved for our most acutely ill patients. While a number of randomised trials have evaluated the optimal timing to start RRT among critically ill patients in the intensive care unit (ICU), there has been a paucity of trials providing guidance on when and under what circumstances to ideally liberate a patient from RRT. We are conducting a systematic review and meta-analysis to identify clinical and biochemical markers that predict kidney recovery and successful liberation from acute RRT among critically ill patients with acute kidney injury...
November 25, 2018: BMJ Open
Elena Bignami, Savino Spadaro, Francesco Saglietti, Antonio Di Lullo, Francesca Dalla Corte, Marcello Guarnieri, Giulio de Simone, Ilaria Giambuzzi, Alberto Zangrillo, Carlo Alberto Volta
BACKGROUND: Lung dysfunction commonly occurs after cardiopulmonary bypass (CPB). Randomized evidence suggests that the presence of expiratory flow limitation (EFL) in major abdominal surgery is associated with postoperative pulmonary complications. Appropriate lung recruitment and a correctly set positive end-expiratory pressure (PEEP) level may prevent EFL. According to the available data in the literature, an adequate ventilation strategy during cardiac surgery is not provided. The aim of this study is to assess whether a mechanical ventilation strategy based on optimal lung recruitment with a best PEEP before and after CPB and with a continuous positive airway pressure (CPAP) during CPB would reduce the incidence of respiratory complications after cardiac surgery...
November 26, 2018: Trials
Mohammed Dhafer AlAhmari, Hajed Al-Otaibi, Hatem Qutub, Ibrahim AlBalawi, Abdullah Alqahtani, Bandar Almasoudi
INTRODUCTION: Noninvasive ventilation (NIV) has been extensively used globally and is often administered as the first-line treatment. Currently, data regarding the utilization of NIV in the Kingdom of Saudi Arabia (KSA) is scarce. The present study aimed to assess and quantify the utilization of NIV in clinical practice across the KSA and investigate obstacles that may cause NIV underutilization. METHODS: A web-based survey composed of a 31-item, self-administered questionnaire was developed and validated...
October 2018: Annals of Thoracic Medicine
Ignacio Fernández-Fígares, Jose Miguel Rodríguez-López, Lucrecia González-Valero, Manuel Lachica
Most valuable cured products from Iberian pigs come from pure bred animals raised for a final grazing-fattening period where pigs eat mainly acorns, a low protein energy rich fruit. This is a nutritional challenge for animals fed equilibrated diets from weaning. The aim of the study was to determine net portal appearance (NPA) of metabolites in gilts fed acorns and evaluate adaptational changes after one week of feeding. Two sampling periods were carried out (after one day and after one week of acorn feeding) with six gilts (34 kg average BW) set up with three catheters: in carotid artery and portal vein for blood sampling, and ileal vein for para-aminohippuric acid (PAH) infusion to measure portal plasma flow (PPF)...
2018: PeerJ
Natalie Schroyens, Crhistian Luis Bender, Joaquín Matias Alfei, Victor Alejandro Molina, Laura Luyten, Tom Beckers
The present study aimed to investigate the influence of housing conditions on contextual fear memory malleability. Male Wistar rats were housed in enriched, standard, or impoverished conditions after weaning and remained in these conditions throughout the entire experiment. After six weeks into those housing conditions, all animals underwent a 3-day protocol including contextual fear conditioning (day 1), memory reactivation followed by systemic administration of midazolam or vehicle (day 2), and a retention test (day 3)...
November 1, 2018: Behavioural Brain Research
Gustavo S Silva, Luis G Corbellini, Daniel L C Linhares, Kimberlee L Baker, Derald J Holtkamp
Biosecurity is defined as the set of practices carried out to prevent the introduction and spread of infectious agents in a herd. These practices are essential in swine production, especially for highly infectious agents such as porcine reproductive and respiratory syndrome virus (PRRSv). Even with years of research and experience over the last three decades, PRRSv is still causing productivity losses and is the major health problem affecting the global swine industry. Despite knowledge of the various ways in which the virus can be transmitted from one herd to another (e...
November 15, 2018: Preventive Veterinary Medicine
Daniel Gomes, José Pimentel, Carla Bentes, Diana Aguiar de Sousa, Ana Patrícia Antunes, António Alvarez, Zélia Costa Silva
INTRODUCTION: Super-refractory status epilepticus is defined as status epilepticus that persists or recurs 24 hours after anaesthetic therapy onset or after its withdrawal. It is mostly found in intensive care units and carries high mortality but good long-term prognosis for those who survive. In contrast with the initial phases of status epilepticus, treatment lacks strong scientific evidence and is mostly derived from case reports or small case series. OBJECTIVE: To propose a protocol for the treatment of super-refractory status epilepticus in level III intensive care units, focusing on the treatment strategies to control clinical and/or electroencephalographic epileptic activity...
October 31, 2018: Acta Médica Portuguesa
Gavin D Perkins, Dipesh Mistry, Simon Gates, Fang Gao, Catherine Snelson, Nicholas Hart, Luigi Camporota, James Varley, Coralie Carle, Elankumaran Paramasivam, Beverley Hoddell, Daniel F McAuley, Timothy S Walsh, Bronagh Blackwood, Louise Rose, Sarah E Lamb, Stavros Petrou, Duncan Young, Ranjit Lall
Importance: In adults in whom weaning from invasive mechanical ventilation is difficult, noninvasive ventilation may facilitate early liberation, but there is uncertainty about its effectiveness in a general intensive care patient population. Objective: To investigate among patients with difficulty weaning the effects of protocolized weaning with early extubation to noninvasive ventilation on time to liberation from ventilation compared with protocolized invasive weaning...
November 13, 2018: JAMA: the Journal of the American Medical Association
Bruno Garcia Montagnini, Karine Vandressa Pernoncine, Lorena Ireno Borges, Nathalia Orlandini Costa, Estefânia Gastadello Moreira, Janete Aparecida Anselmo-Franci, Ana Carolina Inhasz Kiss, Daniela Cristina Ceccatto Gerardin
Triclosan (TCS) is a phenolic compound with antimicrobial action widely used in cosmetics and other personal care products and other industry segments. Its widespread use over the decades has made TCS one of the most commonly detected compounds in wastewater and effluent worldwide already being found in human urine, plasma and milk. In this study, the (anti)estrogenicity of TCS was evaluated in the uterotrophic assay in 18-day old female Wistar rats. In a second protocol, female rats were evaluated for the reproductive effects of TCS in a two-generation reproduction toxicity study...
December 1, 2018: Toxicology
Pedro Espitia-Pérez, Suelen Marin Albino, Lyda Espitia-Pérez, Hugo Brango, Helen da Rosa, Alexandre Kleber Silveira, Diogo Pompéu Moraes, Camila Cerveira, Moara Mingori, Camila Tiefensee Ribeiro, Daniel Pens Gelain, Carlos Eduardo Schnorr, José Cláudio Fonseca Moreira
Fish consumption and ubiquitous methylmercury (MeHg) exposure represent a public health problem globally. Micronutrients presented in fish affects MeHg uptake/distribution. Vitamin A (VitA), another fish micronutrient is used in nutritional supplementation, especially during pregnancy. However, there is no information about the health effects arising from their combined exposure. The present study aimed to examine the effects of both MeHg and retinyl palmitate administered to pregnant and lactating rats. Thirty Wistar female rats were orally supplemented with MeHg (0,5 mg/Kg/day) and retinyl palmitate (7500 μg RAE1 /Kg/day), either individually or in combination from the gestational day 0 to weaning...
October 11, 2018: Neurotoxicology
Michael Salna, Yasuhiro Shudo, Jeffrey J Teuteberg, Dipanjan Banerjee, Richard V Ha, Y Joseph Woo, William Hiesinger
INTRODUCTION: The planned use of a temporary right ventricular assist device (RVAD) at the time of left ventricular assist device (LVAD) implantation may prevent the need for a permanent biventricular assist device (BiVAD). Herein we describe our RVAD weaning protocol that was effectively employed in 4 patients to prevent the need for permanent BiVAD. METHODS: Four patients in refractory cardiogenic shock underwent planned RVAD insertion during LVAD implantation due to severely depressed right ventricular function with dilation preoperatively...
October 1, 2018: Heart Surgery Forum
Masayoshi Inoue
Mechanical ventilation is a useful treatment option for respiratory insufficiency following thoracic and cardiovascular surgery. Ventilation mode is classified as volume-controlled-ventilation(VCV) and pressure-controlled ventilation(PCV). Non-invasive ventilation(NIV) without tracheal intubation has been recently developed and is effective in patients with chronic obstructive pulmonary disease (COPD) exacerbation. Several pulmonary complications by mechanical ventilation such as ventilator-induced lung injury(VILI) or ventilator-associated pneumonia(VAP) could be avoided with NIV...
September 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Ilia Bresesti, Sanja Zivanovic, Kevin Nicolas Ives, Gianluca Lista, Charles Christoph Roehr
AIM: This study compared how non-invasive respiratory support (NRS) was provided in neonatal units in Italy and the UK. METHODS: An NRS questionnaire was sent to tertiary neonatal centres, identified by national societies, from November 2015 to May 2016. RESULTS: Responses were received from 49/57 (86%) UK units and 103/115 (90%) Italian units. NRS was started in the delivery room by 61% of UK units and 85% of Italian units. In neonatal intensive care units, 33% of UK units used nasal high-flow therapy (HFT) as primary support, compared to 3% in Italy...
October 11, 2018: Acta Paediatrica
Jessica H Beeson, Heather L Blackmore, Sarah K Carr, Laura Dearden, Daniella E Duque-Guimarães, Laura C Kusinski, Lucas C Pantaleão, Adele G Pinnock, Catherine E Aiken, Dino A Giussani, Denise S Fernandez-Twinn, Susan E Ozanne
OBJECTIVE: Obesity during pregnancy is associated with an elevated risk of cardiovascular disease in the offspring. With increased numbers of women entering pregnancy overweight or obese, there is a requirement for targeted interventions to reduce disease risk in future generations. Using an established murine model of maternal obesity during pregnancy, we investigated if a treadmill exercise intervention in the mother could improve offspring cardiac health and explored potential underlying mechanisms...
October 2018: Molecular Metabolism
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