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https://www.readbyqxmd.com/read/28919596/outcome-of-pregnancy-related-acute-kidney-injury-observed-in-a-tertiary-care-hospital
#1
S U Ahammed, A A Chowdhury, A S Roy, M A Muqueet, M A Rahman, M S Kabir, M G Rabbani, M Asadujjaman, M B Hossain, M Akhtaruzzaman, S K Das, E H Khan, M A Islam, M J Hasan, M A Rahman, R K Talukder, J Ara, G C Barman, P P Roy, M K Saha, D Mondal
This prospective case control study was carried out in Mymensingh Medical College Hospital (MMCH) from April 2011 to March 2012. The main objective of the study was to determine the short term maternal outcome of pregnancy related Acute Kidney Injury and to identify aetiological factors and to observe clinical features of pregnancy related Acute Kidney Injury. Total 60 pregnant women with AKI were included in the study as sample and equal (60) number of pregnant women with normal renal function was taken as control...
July 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/28916584/novel-insights-into-the-clinical-phenotype-and-pathophysiology-underlying-low-vwf-levels
#2
Michelle Lavin, Sonia Aguila, Sonja Schneppenheim, Niall Dalton, Kenneth L Jones, Jamie M O'Sullivan, Niamh M O'Connell, Kevin Ryan, Barry White, Mary Byrne, Marie Rafferty, Mairead M Doyle, Margaret Nolan, Roger J S Preston, Ulrich Budde, Paula James, Jorge Di Paola, James S O'Donnell
Critical clinical questions remain unanswered regarding diagnosis and management of patients with Low VWF levels (30-50 IU/dL). To address these questions, the Low VWF Ireland Cohort (LoVIC) study investigated 126 patients registered with Low VWF. Interestingly, despite their marginally reduced plasma VWF levels, ISTH BAT and Condensed MCMDM-1 VWD scores both confirmed significant bleeding phenotypes in the majority of LoVIC patients. For example, among female patients with Low VWF, 77% had ISTH BAT scores ≥6...
September 15, 2017: Blood
https://www.readbyqxmd.com/read/28913708/emergency-neurological-life-support-intracerebral-hemorrhage
#3
J Claude Hemphill, Arthur Lam
Intracerebral hemorrhage (ICH) is a subset of stroke due to spontaneous bleeding within the parenchyma of the brain. It is potentially lethal, and survival depends on ensuring an adequate airway, proper diagnosis, and early management of several specific issues such as blood pressure, coagulopathy reversal, and surgical hematoma evacuation for appropriate patients. ICH was chosen as an Emergency Neurological Life Support (ENLS) protocol because intervention within the first hours may improve outcome, and it is critical to have site-specific protocols to drive care quickly and efficiently...
September 14, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28910242/how-does-the-social-get-under-the-gums-the-role-of-socio-economic-position-in-the-oral-systemic-health-link
#4
Noha Gomaa, Belinda Nicolau, Arjumand Siddiqi, Howard Tenenbaum, Michael Glogauer, Carlos Quiñonez
OBJECTIVES: To evaluate the extent of association between systemic inflammation and periodontal disease in American adults, and to assess whether socio-economic position mediated this relationship. METHODS: We used data from the National Health and Nutrition Examination Survey (NHANES IV) (2001-2010). Systemic inflammation was defined by individual and aggregate (cumulative inflammatory load) biomarkers (C-reactive protein, white blood cell counts, neutrophil counts, and neutrophil:lymphocyte ratio)...
September 14, 2017: Canadian Journal of Public Health. Revue Canadienne de Santé Publique
https://www.readbyqxmd.com/read/28902808/-anticoagulant-therapy-of-venous-thromboembolic-complications-balancing-between-risks
#5
K V Lobastov, S V Sapelkin
This article is a review of the literature, related to the problem of recurrence of venous thromboembolic complications and the possibilities of their secondary prevention. The problems of determining the rational duration of anticoagulant therapy on the basis of an individual assessment of its benefit and risk are considered. The information on modern prognostic models allowing quantitative assessment of the probability of hemorrhagic and thrombotic events occurrence is presented (Vienna prediction model, DASH, HAS-BLED, stratification according to ACCP 2016)...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/28894313/need-for-a-randomized-controlled-trial-of-stress-ulcer-prophylaxis-in-critically-ill-children-a-canadian-survey
#6
Mark Duffett, Karen Choong, Jennifer Foster, Elaine Gilfoyle, Jacques Lacroix, Deborah J Cook
BACKGROUND: Stress ulcer prophylaxis is commonly used in pediatric critical care, to prevent upper gastrointestinal bleeding. The most frequently used agents are histamine-2 receptor antagonists (H2RAs) and proton pump inhibitors (PPIs). The risk-benefit ratio for stress ulcer prophylaxis is uncertain, because data from randomized clinical trials (RCTs) on the effectiveness and harms of prophylaxis in children are limited. OBJECTIVE: To describe the views of Canadian pediatric intensivists about a future RCT of stress ulcer prophylaxis...
July 2017: Canadian Journal of Hospital Pharmacy
https://www.readbyqxmd.com/read/28882875/class-iii-pi3k-positively-regulates-platelet-activation-and-thrombosis-via-pi-3-p-directed-function-of-nadph-oxidase
#7
Yangyang Liu, Mengjiao Hu, Dongjiao Luo, Ming Yue, Shuai Wang, Xiaoyan Chen, Yangfan Zhou, Yi Wang, Yanchun Cai, Xiaolan Hu, Yuehai Ke, Zhongzhou Yang, Hu Hu
OBJECTIVE: Class III phosphoinositide 3-kinase, also known as vacuolar protein sorting 34 (VPS34), is a highly conserved enzyme regulating important cellular functions such as NADPH oxidase (NOX) assembly, membrane trafficking, and autophagy. Although VPS34 is expressed in platelets, its involvement in platelet activation remains unclear. Herein, we investigated the role of VPS34 in platelet activation and thrombus formation using VPS34 knockout mice. APPROACH AND RESULTS: Platelet-specific VPS34-deficient mice were generated and characterized...
September 7, 2017: Arteriosclerosis, Thrombosis, and Vascular Biology
https://www.readbyqxmd.com/read/28876055/supramolecular-assembly-of-peptide-amphiphiles
#8
Mark P Hendricks, Kohei Sato, Liam C Palmer, Samuel I Stupp
Peptide amphiphiles (PAs) are small molecules that contain hydrophobic components covalently conjugated to peptides. In this Account, we describe recent advances involving PAs that consist of a short peptide sequence linked to an aliphatic tail. The peptide sequence can be designed to form β-sheets among the amino acids near the alkyl tail, while the residues farthest from the tail are charged to promote solubility and in some cases contain a bioactive sequence. In water, β-sheet formation and hydrophobic collapse of the aliphatic tails induce assembly of the molecules into supramolecular one-dimensional nanostructures, commonly high-aspect-ratio cylindrical or ribbonlike nanofibers...
September 6, 2017: Accounts of Chemical Research
https://www.readbyqxmd.com/read/28875370/how-prepared-are-pharmacists-to-support-atrial-fibrillation-patients-in-adhering-to-newly-prescribed-oral-anticoagulants
#9
Nadya Hamedi, Filipa Alves da Costa, Robert Horne, Michael Levitan, Amanda Begley, Sotiris Antoniou
Background The New Medicines Service (NMS) was implemented in the United Kingdom in 2011 and first evaluated in 2014, showing 10% increase on adherence. Objective To assess community pharmacists' current practice, knowledge and confidence in supporting patients' adherence as part of the NMS for patients on Oral Anti-Coagulants (OACs) for stroke prevention in Atrial Fibrillation. Setting Community pharmacists in London. Method An online cross-sectional survey was sent to pharmacists from their Local Pharmaceutical Committees and advertised by the Royal Pharmaceutical Society...
September 5, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28870876/prevalence-and-impact-of-critical-limb-ischemia-on-in-hospital-outcome-in-transcatheter-aortic-valve-implantation-in-germany
#10
Nasser M Malyar, Klaus Kaier, Eva Freisinger, Florian Lüders, Gerrit Kaleschke, Helmut Baumgartner, Lutz Frankenstein, Holger Reinecke, Jochen Reinöhl
AIMS: Peripheral artery disease (PAD) is common in patients with aortic valve stenosis (AS). We assessed the prevalence of critical limb ischemia (CLI) and its impact on in-hospital outcome in patients undergoing transcatheter aortic valve implantation (TAVI) for severe AS. METHODS AND RESULTS: All isolated TAVI in Germany between 2007 and 2013 for AS were analysed regarding stage specific prevalence of PAD, comorbidities, in-hospital complications and mortality using diagnostic and procedural codes...
September 5, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28865339/enteral-nutrition-as-stress-ulcer-prophylaxis-in-critically-ill-patients-a-randomized-controlled-exploratory-study
#11
Karim El-Kersh, Bilal Jalil, Stephen A McClave, Rodrigo Cavallazzi, Juan Guardiola, Karen Guilkey, Annuradha K Persaud, Stephen P Furmanek, Brian E Guinn, Timothy L Wiemken, Mohamed Saad
PURPOSE: We investigated whether early enteral nutrition alone may be sufficient prophylaxis against stress-related gastrointestinal (GI) bleeding in mechanically ventilated patients. MATERIALS AND METHODS: Prospective, double blind, randomized, placebo-controlled, exploratory study that included mechanically ventilated patients in medical ICUs of two academic hospitals. Intravenous pantoprazole and early enteral nutrition were compared to placebo and early enteral nutrition as stress-ulcer prophylaxis...
August 26, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28862718/clinical-impact-of-regional-citrate-anticoagulation-in-continuous-renal-replacement-therapy-in-critically-ill-patients
#12
Maria Huguet, Lida Rodas, Miquel Blasco, Luis F Quintana, Jordi Mercadal, Jose T Ortiz-Pérez, Irene Rovira, Esteban Poch
BACKGROUND: Regional citrate anticoagulation (RCA) is being used increasingly in continuous renal replacement therapy (CRRT) as a safer alternative to heparin. However, complex metabolic control to avoid side effects have generated discrepancies about its introduction into everyday practice. We aimed to compare both anticoagulation techniques in terms of efficacy, safety and feasibility. METHODS: Observational retrospective study performed in 3 specialized ICUs in patients receiving CVVHDF with RCA between January 2013 and May 2016...
August 17, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28860793/evaluation-of-bleeding-in-patients-receiving-direct-oral-anticoagulants
#13
REVIEW
Erika L Hellenbart, Kathleen D Faulkenberg, Shannon W Finks
Direct oral anticoagulants (DOACs) are recognized by evidence-based treatment guidelines as the first-line option for the treatment of venous thromboembolism and prevention of stroke and systemic embolism in nonvalvular atrial fibrillation. As use of these anticoagulants has become favored over the past several years, reported bleeding-related adverse drug events with these agents has increased. In randomized clinical trials, all DOACs have a reduced risk for intracranial hemorrhage, while major and other bleeding results have varied among the agents compared to vitamin K antagonists...
2017: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/28858106/robot-assisted-internal-mammary-lymph-chain-excision-for-breast-cancer-a-case-report
#14
Junze Du, Hongbiao Mo, Linjun Fan, Jun Jiang
RATIONALE: Understanding the status of internal mammary lymph nodes of breast cancer is critical in the accurate staging of breast cancer and the development of accurate therapeutic regimen for selected patients. Current techniques for dissection of internal mammary lymph node biopsy involve endoscopic or Traditional thoracic surgery, An important drawback of the current techniques is the great trauma caused by them. PATIENT CONCERNS: Da Vinci robotic surgery system (Intuitive Surgical Inc...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28857854/heparin-free-prolonged-intermittent-hemodialysis-using-calcium-free-citrate-dialysate-in-critically-ill-patients
#15
Stanislas Faguer, Morgane Saint-Cricq, Marie-Béatrice Nogier, Isabelle Labadens, Laurence Lavayssiere, Nassim Kamar, Olivier Cointault
OBJECTIVES: Critically ill patients who have a high risk of bleeding but require prolonged intermittent dialysis need a heparin-free easy-to-use alternative type of anticoagulation within the dialysis circuit. We assessed the safety and efficiency of heparin-free regional citrate anticoagulation of the dialysis circuit using a calcium-free citrate-containing dialysate, with calcium reinjected according to ionic dialysance. DESIGN: Prospective cohort study. SETTING: Critical care units...
August 28, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28857793/initiation-and-termination-of-massive-transfusion-protocols-current-strategies-and-future-prospects
#16
John C Foster, Joshua W Sappenfield, Robert S Smith, Sean P Kiley
The advent of massive transfusion protocols (MTP) has had a significant positive impact on hemorrhaging trauma patient morbidity and mortality. Nevertheless, societal MTP guidelines and individual MTPs at academic institutions continue to circulate opposing recommendations on topics critical to MTPs. This narrative review discusses up-to-date information on 2 such topics, the initiation and termination of an MTP. The discussion for each begins with a review of the recommendations and supporting literature presented by MTP guidelines from 3 prominent societies, the American Society of Anesthesiologists, the American College of Surgeons, and the task force for Advanced Bleeding Care in Trauma...
August 29, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28851694/dose-optimisation-of-intravenous-tranexamic-acid-for-elective-hip-and-knee-arthroplasty-the-effectiveness-of-a-single-pre-operative-dose
#17
R J M Morrison, B Tsang, W Fishley, I Harper, J C Joseph, M R Reed
OBJECTIVES: We have increased the dose of tranexamic acid (TXA) in our enhanced total joint recovery protocol at our institution from 15 mg/kg to 30 mg/kg (maximum 2.5 g) as a single, intravenous (IV) dose. We report the clinical effect of this dosage change. METHODS: We retrospectively compared two cohorts of consecutive patients undergoing total hip arthroplasty (THA) or total knee arthroplasty (TKA) surgery in our unit between 2008 and 2013. One group received IV TXA 15 mg/kg, maximum 1...
August 2017: Bone & Joint Research
https://www.readbyqxmd.com/read/28846787/comparison-of-clinical-outcomes-using-a-piezosurgery-device-vs-a-conventional-osteotome-for-lateral-osteotomy-in-rhinoplasty
#18
Bulent Koc, Eltaf Ayca Koc, Selim Erbek
Our aim for this study was to evaluate and compare the clinical outcomes in patients who underwent lateral osteotomy with a Piezosurgery device or a conventional osteotome in open-technique rhinoplasty. This cohort trial involved 65 patients (36 women and 29 men; average age: 23.6 ± 5.71 yr) who underwent surgery between May 2015 and January 2016. Piezosurgery was used for lateral osteotomy in 32 patients, whereas 33 patients underwent conventional external osteotomy. These 2 groups were compared for duration of surgery, perioperative bleeding, postoperative edema, ecchymosis, pain, and patient satisfaction on the first and seventh postoperative days...
August 2017: Ear, Nose, & Throat Journal
https://www.readbyqxmd.com/read/28844961/mitochondrial-dysfunction-in-rat-splenocytes-following-hemorrhagic-shock
#19
Marie Warren, Kumar Subramani, Richard Schwartz, Raghavan Raju
The regulation of mitochondrial function is critical in cellular homeostasis following hemorrhagic shock. Hemorrhagic shock results in fluid loss and reduced availability of oxygen and nutrients to tissues. The spleen is a secondary lymphoid organ playing a key role in 'filtering the blood' and in the innate and adaptive immune responses. To understand the molecular basis of hemorrhagic shock, we investigated the changes in splenocyte mitochondrial respiration, and concomitant immune and metabolic alterations...
August 26, 2017: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/28833353/assessment-of-an-extended-interval-fondaparinux-dosing-regimen-for-venous-thromboembolism-prophylaxis-in-critically-ill-patients-with-severe-renal-dysfunction-using-antifactor-xa-levels
#20
Krista A Wahby, Lauren K Riley, Steven D Tennenberg
OBJECTIVE: Pharmacologic options for venous thromboembolism (VTE) prophylaxis are often limited in critically ill patients due to thrombocytopenia and multisystem organ dysfunction. Fondaparinux offers potential advantages in the critically ill; however, it is currently contraindicated in severe renal dysfunction (SRD). We evaluated antifactor Xa levels in critically ill patients with SRD who were receiving an extended interval dosing regimen of fondaparinux for VTE prophylaxis. METHODS: A prospective, single arm, interventional study was conducted at two academic hospitals of the Detroit Medical Center...
August 22, 2017: Pharmacotherapy
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