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https://www.readbyqxmd.com/read/28938507/-hypertensive-emergencies
#1
Gerd Bönner
Hypertensive urgency and hypertensive emergency are associated with sudden, massive rise in blood pressure. An acute increase in blood pressure to values above 180/120 mmHg is considered critical. If not treated in time, it can quickly enter a life-threatening hypertensive emergency. The symptoms or organ damage determine the assessment as a crisis or an emergency. Rapid action is required. The therapy depends on the severity and the organ involvement. However the general principal is to avoid therapeutically induced hypotension...
September 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28938048/a-predictive-score-for-hypotension-in-patients-with-confirmed-dengue-fever-in-cayenne-hospital-french-guiana
#2
Félix Djossou, Guillaume Vesin, Narcisse Elenga, Magalie Demar, Loïc Epelboin, Gaëlle Walter, Philippe Abboud, Thierry Le-Guen, Dominique Rousset, Brigitte Moreau, Aba Mahamat, Denis Malvy, Mathieu Nacher
Background: Identifying patients at risk of developing severe dengue is challenging. The objective of the present study was to determine the incidence of hypotension and its predictive factors during the Dengue 2 epidemic in 2013. Methods: In 2013, a longitudinal study was performed using data from all confirmed cases of dengue seen in Cayenne General Hospital. The analysis used Cox proportional modeling to obtain adjusted hazards ratios for hypotension. Results: A total of 806 confirmed patients were included 78 (9...
December 1, 2016: Transactions of the Royal Society of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28936180/mouse-anaphylactic-hypotension-is-characterized-by-initial-baroreflex-independent-renal-sympathoinhibition-followed-by-sustained-renal-sympathoexcitation
#3
Tao Zhang, Mamoru Tanida, Kunitoshi Uchida, Yoshiro Suzuki, Wei Yang, Yuhichi Kuda, Yasutaka Kurata, Makoto Tominaga, Toshishige Shibamoto
Aim: The hemodynamic response to mouse systemic anaphylaxis is characterized by an initial hypertension followed by sustained hypotension. However, the defense mechanisms of the sympathetic nervous system against this circulatory disturbance is not known. Here, we investigated the renal sympathetic nerve activity (RSNA) response to mouse systemic anaphylaxis, along with the roles of carotid sinus baroreceptor, vagal nerves and the transient receptor potential vanilloid type 1 channel (TRPV1). Methods: Male ovalbumin-sensitized C57BL/6N mice were used under pentobarbital anesthesia...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28934778/the-effect-of-early-use-of-supplemental-therapy-on-preventing-postherpetic-neuralgia-a-systematic-review-and-meta-analysis
#4
Xiu-Fang Xing, Zhen-Feng Zhou, Feng-Jiang Zhang, Min Yan
BACKGROUND: Postherpetic neuralgia (PHN) is the most common and refractory complication of herpes zoster (HZ). Aggressive treatment of acute pain in HZ has the potential to prevent the development of PHN, but the preventive efficacy of supplemental therapy commonly used in clinical practice is controversial. OBJECTIVES: Our aim is to examine the efficacy of supplemental therapy in preventing PHN. STUDY DESIGN: A meta-analysis. SETTING: All of the selected studies are randomized controlled trials (RCTs)...
September 2017: Pain Physician
https://www.readbyqxmd.com/read/28934599/rewarming-after-severe-accidental-hypothermia-using-the-esophageal-heat-transfer-device-a-case-report
#5
Katarina Katja Primožič, Franci Svenšek, Andrej Markota, Andreja Sinkovič
Patients with severe accidental hypothermia require active rewarming. External rewarming may not be successful in severe hypothermia, and use of invasive techniques is limited to regional centers and is associated with vascular access site and other complications. We present a patient with severe accidental hypothermia who was successfuly rewarmed using a novel esophageal heat transfer device. A 55-year-old male (175 cm, 71 kg) was admitted with the first recorded temperature 23.3°C. Rewarming using renal replacement therapy circuit was unsuccessful because of severe hypotension...
September 21, 2017: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/28930954/acute-procedural-interventions-after-pediatric-blunt-abdominal-trauma-a-prospective-multicenter-evaluation
#6
Chase A Arbra, Adam M Vogel, Jingwen Zhang, Patrick D Mauldin, Eunice Y Huang, Kate B Savoie, Matthew T Santore, KuoJen Tsao, Tiffany G Ostovar-Kermani, Richard A Falcone, M Sidney Dassinger, John Recicar, Jeffrey H Haynes, Martin L Blakely, Robert T Russell, Bindi J Naik-Mathuria, Shawn D St Peter, David P Mooney, Chinwendu Onwubiko, Jeffrey S Upperman, Christian J Streck
BACKGROUND: Pediatric intra-abdominal injuries (IAI) from blunt abdominal trauma (BAT) rarely require emergent intervention. For those children undergoing procedural intervention, our aim was to understand the timing and indications for operation and angiographic embolization. METHODS: We prospectively enrolled children younger than 16 years after BAT at 14 Level I Pediatric Trauma Centers over a 1-year period. Patients with IAI who received an intervention (IAI-I) were compared with those who did not receive an intervention using descriptive statistics and univariate analysis; p less than 0...
October 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28930950/increased-mortality-in-trauma-patients-who-develop-postintubation-hypotension
#7
Robert S Green, Michael B Butler, Mete Erdogan
BACKGROUND: Postintubation hypotension (PIH) is common and associated with poor outcomes in critically ill patient populations requiring emergency endotracheal intubation (ETI). The importance of PIH in the trauma population remains unclear. The objective of this study was to determine the prevalence of PIH in trauma patients and assess the association of PIH with patient outcomes. METHODS: Retrospective case series of adult (≥16 years) patients who were intubated on arrival at a tertiary trauma center in Halifax, Nova Scotia, Canada, between 2000 and 2015...
October 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28930948/is-post-intubation-hypotension-really-a-determinant-of-increased-mortality-in-traumatic-patients
#8
Chao Wen, Fu-Shan Xue, Hui-Xian Li, Ya-Yang Liu
No abstract text is available yet for this article.
September 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28930834/allergic-shock-caused-by-ingestion-of-cooked-jellyfish-a-case-report
#9
Zhixing Li, Xungang Tan, Botao Yu, Renliang Zhao
RATIONALE: Although anaphylaxis caused by jellyfish stings is common in coastal areas, an allergic shock caused by cooked jellyfish ingestion has never been reported in China. In this paper, we report a case of allergic shock being caused by ingestion of cooked salt-preserved jellyfish shortly after being stung by a live jellyfish. PATIENT CONCERNS: A 26-year-old Chinese man presented with dizziness, pruritus, dyspnea, hypotension, and tachycardia after eating cooked salted jellyfish...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28929576/systolic-orthostatic-hypotension-is-related-to-lowered-cognitive-function-findings-from-the-maine-syracuse-longitudinal-study
#10
Rachael V Torres, Merrill F Elias, Georgina E Crichton, Gregory A Dore, Adam Davey
The aim of the present study was to examine the relationship between orthostatic changes in blood pressure (BP) and cognition, with consideration given to cardiovascular risk factors and lifestyle variables. The cross-sectional analysis included 961 community-dwelling participants of the Maine-Syracuse Longitudinal Study, for whom BP clinic measures (five sitting, five recumbent, and five standing) were obtained. Eighteen percent of participants had orthostatic hypotension (fall in systolic BP ≥20 mm Hg or diastolic BP ≥10 mm Hg upon standing) and 6% had orthostatic hypertension (rise in systolic BP ≥20 mm Hg)...
September 19, 2017: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/28929392/preventing-early-bouncebacks-to-the-neurointensive-care-unit-a-retrospective-analysis-and-quality-improvement-pilot
#11
David G Coughlin, Monisha A Kumar, Neha N Patel, Rebecca L Hoffman, Scott E Kasner
BACKGROUND: Early unplanned readmissions of "bouncebacks" to intensive care units are a healthcare quality metric and result in higher mortality and greater cost. Few studies have examined bouncebacks to the neurointensive care unit (neuro-ICU), and we sought to design and implement a quality improvement pilot to reduce that rate. METHODS: First, we performed a retrospective chart review of 504 transfers to identify potential bounceback risk factors. Risk factors were assessed on the day of transfer by the transferring physician identifying patients as "high risk" or "low risk" for bounceback...
September 19, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28928589/laparoscopic-cholecystectomy-under-segmental-thoracic-spinal-anesthesia-a-feasible-economical-alternative
#12
Aditya Kumar Kejriwal, Shaheen Begum, Gopal Krishan, Richa Agrawal
Laparoscopic surgery is normally performed under general anesthesia, but regional techniques like thoracic epidural and lumbar spinal have been emerging and found beneficial. We performed a clinical case study of segmental thoracic spinal anaesthesia in a healthy patient. We selected an ASA grade I patient undergoing elective laparoscopic cholecystectomy and gave spinal anesthetic in T10-11 interspace using 1 ml of bupivacaine 5 mg ml(-1) mixed with 0.5 ml of fentanyl 50 μg ml(-1). Other drugs were only given (systemically) to manage patient anxiety, pain, nausea, hypotension, or pruritus during or after surgery...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28928581/a-comparative-study-of-intravenous-esmolol-labetalol-and-lignocaine-in-low-doses-for-attenuation-of-sympathomimetic-responses-to-laryngoscopy-and-endotracheal-intubation
#13
Ekta Ratnani, Om Prakash Sanjeev, Abhishek Singh, Manoj Tripathi, Hemant Kumar Chourasia
BACKGROUND: Direct layngoscopy and endotracheal intubation is a noxious stimuli and induces sympathomimetic responses. Although well tolerated in healthy subjects, it may impose life threatening arrhythmias, left ventricular failure or rupture of cerebral aneurysm in susceptible patients. Esmolol, Labetalol and Lignocaine attenuate these responses but are associated with side effects of bradycardia, hypotension etc. In lower doses, chances of these side effects are comparatively low. So we designed this prospective clinical trial to assess the efficacy of intravenous esmolol, labetalol and lignocaine in low doses for attenuation of sympathomimetic responses to endotracheal intubation...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28925664/preventing-falls-in-older-persons
#14
Lainie Van Voast Moncada, L Glen Mire
The American Geriatrics Society and British Geriatrics Society recommend that all adults older than 65 years be screened annually for a history of falls or balance impairment. The U.S. Preventive Services Task Force and American Academy of Family Physicians recommend exercise or physical therapy and vitamin D supplementation to prevent falls in community-dwelling older adults who are at increased risk of falls. Although the U.S. Preventive Services Task Force and American Academy of Family Physicians do not recommend routine multifactorial intervention to prevent falls in all community-dwelling older adults, they state that it may be appropriate in individual cases...
August 15, 2017: American Family Physician
https://www.readbyqxmd.com/read/28925169/-systematic-review-on-safety-of-salvianolate-injection
#15
Zhi-Wei Chen, Yan-Ming Xie, Xing Liao, Gui-Qian Wang
To systematically evaluate the safety of salvianolate injection in clinical medication. A systematic literature search was performed in the databases of Cochrane Library, Medline, Embase, the Web of Science, Clinical Trials, CNKI, VIP, WanFang Data and CBM. Literature screening was done according to inclusion and exclusion criteria, and quality was assessed according to internationally recognized quality evaluation criteria. Then the data were reviewed for analysis. 148 papers were included, consisting of 122 randomized controlled trials(RCTs), 10 non-randomized controlled trials(NRCTs), 4 case series studies, and 12 case reports...
October 2016: Zhongguo Zhong Yao za Zhi, Zhongguo Zhongyao Zazhi, China Journal of Chinese Materia Medica
https://www.readbyqxmd.com/read/28924323/intracranial-hypotension-an-uncommon-entity-with-common-presentation
#16
Vinay K Maurya, R Ravikumar, Mukul Bhatia, Y S Sirohi
Headache disorders are among the most common presenting complaints in any neurology outpatient department. International Headache Society classifies headaches as "primary" or "secondary". The causes of secondary headaches are varied and intracranial hypotension is one of them. It typically presents clinically with postural headaches but most of the times, its diagnosis is delayed, as it is an uncommon cause and there is poor awareness among the medical fraternity about this condition. Imaging, especially magnetic resonance imaging (MRI), plays a crucial role in the diagnosis of intracranial hypotension by not only confirming the diagnosis but also detecting the cause in some cases...
April 2017: Medical Journal, Armed Forces India
https://www.readbyqxmd.com/read/28923410/extended-case-duration-and-hypotension-are-associated-with-higher-grade-postoperative-complications-after-urinary-diversion-for-non-oncological-disease
#17
Y Santiago-Lastra, Michael R Mathis, Elizabeth Andraska, Aleda L Thompson, Bahaa S Malaeb, Anne P Cameron, J Quentin Clemens, John T Stoffel
OBJECTIVE: To report survival for patients who undergo urinary diversion for benign indications and to identify risk factors for morbidity at 90 days. METHODS: This is a retrospective review of consecutive urinary diversions with or without cystectomy for non-oncological indications at a single institution. The indication for diversion was intractable incontinence, upper tract deterioration, urinary fistula, and unmanageable bladder pain. Patients were categorized according to their most severe complication within 90 days of surgery, using the Clavien-Dindo system...
September 15, 2017: Urology
https://www.readbyqxmd.com/read/28922683/reproducibility-reliability-and-agreement-of-post-exercise-hypotension
#18
Rafael Yokoyama Fecchio, Marcel Chehuen, Leandro Campos Brito, Tiago Peçanha, Andréia Cristiane Carrenho Queiroz, Claudia Lucia de Moraes Forjaz
This study determined the reproducibility of post-exercise hypotension (PEH) calculated by the following methods: PEH_I=post-exercise BP - pre-exercise BP; PEH_II=post-exercise BP - post-control BP; and PEH_III=[(post-exercise BP - pre-exercise BP)-(post-control BP - pre-control BP)]. Twenty-five participants underwent four sessions divided in two blocks (test and retest). Each block consisted of one exercise and one control session. BP pressure was measured before and after the interventions. The presence of systematic error (paired t-tests), reliability [intraclass coefficient correlation (ICC)], and agreement [typical error (TE) and minimal detectable difference (MDD)] were evaluated...
September 18, 2017: International Journal of Sports Medicine
https://www.readbyqxmd.com/read/28922340/the-impact-of-continuous-non-invasive-arterial-blood-pressure-monitoring-on-blood-pressure-stability-during-general-anaesthesia-in-orthopaedic-patients-a-randomised-trial
#19
Agnes S Meidert, Johanna S Nold, Roman Hornung, Alexander C Paulus, Bernhard Zwißler, Stephan Czerner
BACKGROUND: In patients undergoing general anaesthesia, intraoperative hypotension occurs frequently and is associated with adverse outcomes such as postoperative acute kidney failure, myocardial infarction or stroke. A history of chronic hypertension renders patients more susceptible to a decrease in blood pressure (BP) after induction of general anaesthesia. As a patient's BP is generally monitored intermittently via an upper arm cuff, there may be a delay in the detection of hypotension by the anaesthetist...
September 15, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28922233/endoscopic-versus-open-repair-for-craniosynostosis-in-infants-using-propensity-score-matching-to-compare-outcomes-a-multicenter-study-from-the-pediatric-craniofacial-collaborative-group
#20
Douglas R Thompson, David Zurakowski, Charles M Haberkern, Paul A Stricker, Petra M Meier
BACKGROUND: The North American Pediatric Craniofacial Collaborative Group (PCCG) established the Pediatric Craniofacial Surgery Perioperative Registry to evaluate outcomes in infants and children undergoing craniosynostosis repair. The goal of this multicenter study was to utilize this registry to assess differences in blood utilization, intensive care unit (ICU) utilization, duration of hospitalization, and perioperative complications between endoscopic-assisted (ESC) and open repair in infants with craniosynostosis...
September 14, 2017: Anesthesia and Analgesia
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