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https://www.readbyqxmd.com/read/29423881/the-curious-tale-of-perioperative-precision-medicine-a-story-of-hydroxocobalamin-and-cardiac-surgery-associated-vasoplegia
#1
EDITORIAL
Miklos D Kertai, Andrew D Shaw
No abstract text is available yet for this article.
February 8, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29417853/challenges-in-the-diagnosis-of-acute-cyanide-poisoning
#2
J L Parker-Cote, J Rizer, J P Vakkalanka, S V Rege, C P Holstege
OBJECTIVE: The aim of this systematic review was to identify isolated acute cyanide poison cases and to identify reported signs, symptoms, and laboratory findings. METHODS: We searched MEDLINE, Cochrane Reviews, and Web of Science case reports and series using a number of MeSH descriptors pertaining to cyanide, toxicity, and poisonings. We excluded studies on plants, laboratory analyses, smoke inhalation poisonings, animals as well as non-English language articles and those in which data were not available...
February 8, 2018: Clinical Toxicology
https://www.readbyqxmd.com/read/29395761/cyanide-poisoning-is-a-possible-cause-of-cardiac-arrest-among-fire-victims-and-empiric-antidote-treatment-may-improve-outcomes
#3
Yasuhiko Kaita, Takehiko Tarui, Takahiro Shoji, Hiroshi Miyauchi, Yoshihiro Yamaguchi
BACKGROUND: Carbon monoxide and cyanide poisoning are important causes of death due to fire. Carbon monoxide is more regularly assessed than cyanide at the site of burn or smoke inhalation treatment due to its ease in assessment and simplicity to treat. Although several forensic studies have demonstrated the significance of cyanide poisoning in fire victims using blood cyanide levels, the association between the cause of cardiac arrest and the concentration of cyanide among fire victims has not been sufficiently investigated...
January 22, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29259082/cyanide-production-by-chromobacterium-piscinae-shields-it-from-bdellovibrio-bacteriovorus-hd100-predation
#4
Wonsik Mun, Heeun Kwon, Hansol Im, Seong Yeol Choi, Ajay K Monnappa, Robert J Mitchell
Predation of Chromobacterium piscinae by Bdellovibrio bacteriovorus HD100 was inhibited in dilute nutrient broth (DNB) but not in HEPES. Experiments showed that the effector responsible was present in the medium, as cell-free supernatants retained the ability to inhibit predation, and that the effector was not toxic to B. bacteriovorus Violacein, a bisindole secondary metabolite produced by C. piscinae, was not responsible. Further characterization of C. piscinae found that this species produces sufficient concentrations of cyanide (202 µM) when grown in DNB to inhibit the predatory activity of B...
December 19, 2017: MBio
https://www.readbyqxmd.com/read/29243660/lactate-blood-measurement-in-acute-cyanide-poisoning-effect-of-preanalytical-delay-and-hydroxocobalamin-uses-as-treatment
#5
Pascal Houzé, Marie Laforge, Frédéric J Baud
We quantify the impact of several variables including site of blood draw, delay in measurement, and use of the cyanide antidote hydroxocobalamin on detection of both normal (<2 mmol/L) and elevated (>6 mmol/L) human plasma lactate. An in vivo study assessed effects of venous or arterial origin of blood samples. Two in vitro studies assessed the effect of a 2 h delay in measuring plasma lactate concentrations, as well as the interference of low (100 μmol/L) and high (300 μmmol/L) plasma hydroxocobalamin concentrations on detecting normal and elevated levels of lactate...
December 15, 2017: Annales de Biologie Clinique
https://www.readbyqxmd.com/read/29223724/vasoplegia-after-cardiovascular-procedures-pathophysiology-and-targeted-therapy
#6
REVIEW
Shahzad Shaefi, Aaron Mittel, John Klick, Adam Evans, Natalia S Ivascu, Jacob Gutsche, John G T Augoustides
Vasoplegic syndrome, characterized by low systemic vascular resistance and hypotension in the presence of normal or supranormal cardiac function, is a frequent complication of cardiovascular surgery. It is associated with a diffuse systemic inflammatory response and is mediated largely through cellular hyperpolarization, high levels of inducible nitric oxide, and a relative vasopressin deficiency. Cardiopulmonary bypass is a particularly strong precipitant of the vasoplegic syndrome, largely due to its association with nitric oxide production and severe vasopressin deficiency...
October 27, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29209927/hydroxocobalamin-for-the-treatment-of-cardiac-surgery-associated-vasoplegia-a-case-series
#7
Pranav R Shah, Penny S Reynolds, Nirvik Pal, Daniel Tang, Harry McCarthy, Bruce D Spiess
PURPOSE: Vasoplegia is a clinical syndrome marked by severe arteriolar vasodilatation, hypotension, and low systemic vascular resistance refractory to multiple vasopressor treatment. We report our experience with hydroxocobalamin (B12) infusion as a potential rescue adjunct for refractory vasoplegia during cardiopulmonary bypass (CPB). METHODS: We performed a retrospective chart review of 33 patients undergoing cardiac surgery between 1 January 2013 and 31 December 2015, who were given intravenous B12 for refractory hypotension during, or immediately following, CPB...
December 5, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29205285/vitamin-b12-association-with-mabs-mechanism-and-potential-mitigation-strategies
#8
Cheng Du, Robert Martin, Yunping Huang, Ameya Borwankar, Zhijun Tan, Jay West, Nripen Singh, Michael Borys, Sanchayita Ghose, Richard Ludwig, Li Tao, Zheng Jian Li
Process control for manufacturing biologics is critical for ensuring product quality, safety, and lot to lot consistency of therapeutic proteins. In this study, we investigated the root cause of the pink coloration observed for various in-process pools and drug substances in the antibody manufacturing process. Vitamin B12 is covalently bound to mAbs via a cobalt-sulfur coordinate bond via the cysteine residues. The vitamin B12 was identified to attach to an IgG4 molecule at cysteine residues on light chain (Cys-214), and heavy chain (Cys-134, Cys-321, Cys-367, and Cys-425)...
December 2, 2017: Biotechnology and Bioengineering
https://www.readbyqxmd.com/read/29164951/letter-in-response-to-acquired-methemoglobinemia-after-hydroxocobalamin-administration-in-a-patient-with-burns-and-inhalation-injury
#9
Ryland W Pace, Daniel Lugassy, Robert S Hoffman
No abstract text is available yet for this article.
November 22, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/29045954/-pulmonary-arterial-hypertension-as-leading-manifestation-of-methylmalonic-aciduria-clinical-characteristics-and-gene-testing-in-15-cases
#10
X Q Liu, H Yan, J X Qiu, C Y Zhang, J G Qi, X Zhang, H J Xiao, Y L Yang, Y H Chen, J B DU
OBJECTIVE: To deepen our understanding of Methylmalonic aciduria (MMA) associated pulmonary hypertension (PH) by analyzing the characteristics of clinical presentation, pulmonary high resolusion CT(HRCT), treatment response and gene mutation. METHODS: This study includes 15 cases of pediatric patients with MMA associated PH diagnosed and treated in Peking University First Hospital pediatric department between May 2012 and May 2016 with symptoms of PH as their leading presentation...
October 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/29038891/increase-in-circulating-holotranscobalamin-after-oral-administration-of-cyanocobalamin-or-hydroxocobalamin-in-healthy-adults-with-low-and-normal-cobalamin-status
#11
Eva Greibe, Namita Mahalle, Vijayshri Bhide, Christian W Heegaard, Sadanand Naik, Ebba Nexo
PURPOSE: To investigate the absorption of synthetic cyanocobalamin and natural occurring hydroxocobalamin in populations with low and normal cobalamin (vitamin B12) status. METHODS: We included adults with low (n = 59) and normal (n = 42) cobalamin status and measured the change in serum holotranscobalamin (ΔholoTC) before and after 2 day administration of different doses of cyanocobalamin and hydroxocobalamin (CobaSorb test). In the low status group, the test was performed using a cross-over design with identical doses of both cobalamin forms (1...
October 16, 2017: European Journal of Nutrition
https://www.readbyqxmd.com/read/29031734/residual-no-modulates-contractile-responses-and-membrane-potential-in-isolated-rat-mesenteric-arteries
#12
Olcay Ergürhan Kıroğlu, Özlem Yorulmaz Özü, Mustafa Emre, İhsan Bayel, Eda Karabal Kumcu, M Ata Seçilmiş
Shear stress or vasocontriction causes endothelial nitric oxide (NO) release resulting in the regulation of vascular smooth muscle tone in small resistance arteries. Generation of NO is inhibited by nitric oxide synthase (NOS) inhibitors. In this study, we investigated the effect of residual NO, released even in the presence of NOS inhibitors, on the membrane depolarization and phenylephrine-induced contractions of smooth muscle. For this purpose, we used hydroxocobalamin (HC), an NO scavenger, in the presence of NOS inhibitiors, Nω-nitro- L-arginine (L-NA) or Nω-nitro-L-arginine methyl ester (L-NAME) in mesenteric arteries isolated from rats...
October 12, 2017: Nitric Oxide: Biology and Chemistry
https://www.readbyqxmd.com/read/29021725/prehospital-hydroxocobalamin-for-inhalation-injury-and-cyanide-toxicity-in-the-united-states-analysis-of-a-database-and-survey-of-ems-providers
#13
M V Purvis, H Rooks, J Young Lee, S Longerich, S A Kahn
Prehospital use of hydroxocobalamin as an antidote for cyanide toxicity, a serious complication of smoke inhalation, has yet to be universally adopted in the United States though its efficacy and safety have been demonstrated since 2006. The purpose of this study was to characterize practices of prehospital hydroxocobalamin administration via a survey of emergency medical services (EMS) and to report a case series from an EMS database to track use of hydroxocobalamin. The Fire Smoke Coalition Newsletter emailed a voluntary survey to EMS subscribers regarding hydroxocobalamin use...
June 30, 2017: Annals of Burns and Fire Disasters
https://www.readbyqxmd.com/read/28994688/the-use-of-intravenous-hydroxocobalamin-as-a-rescue-in-methylene-blue-resistant-vasoplegic-syndrome-in-cardiac-surgery
#14
Yi Cai, Anwar Mack, Beth L Ladlie, Archer Kilbourne Martin
Vasoplegic syndrome is a well-recognized complication during cardiopulmonary bypass (CPB) and is associated with increased morbidity and mortality, especially when refractory to conventional vasoconstrictor therapy. This is the first reported case of vasoplegia on CPB unresponsive to methylene blue whereas responsive to hydroxocobalamin, which indicates that the effect of hydroxocobalamin outside of the nitric oxide system is significant or that the two drugs have a synergistic effect in one or multiple mechanisms...
October 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28969436/acquired-methemoglobinemia-after-hydroxocobalamin-administration-in-a-patient-with-burns-and-inhalation-injury
#15
Alisha Z Jiwani, Vikhyat S Bebarta, Leopoldo C Cancio
CONTEXT: Hydroxocobalamin is an effective cyanide antidote. While erythema, hypertension, and chromaturia are recognized side effects, methemoglobinemia has not been reported. Methemoglobin levels are most accurately measured by co-oximetry. We describe an extensively burned patient who developed methemoglobinemia within an hour of hydroxocobalamin administration. CASE DETAILS: A 47-year old man without genetic deficiencies or abnormal hemoglobin variants presented with 61% body surface area thermal burns and grade 1 inhalation injury sustained during a tugboat engine explosion...
October 3, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28912981/physician-beware-severe-cyanide-toxicity-from-amygdalin-tablets-ingestion
#16
Tam Dang, Cham Nguyen, Phu N Tran
Despite the risk of cyanide toxicity and lack of efficacy, amygdalin is still used as alternative cancer treatment. Due to the highly lethal nature of cyanide toxicity, many patients die before getting medical care. Herein, we describe the case of a 73-year-old female with metastatic pancreatic cancer who developed cyanide toxicity from taking amygdalin. Detailed history and physical examination prompted rapid clinical recognition and treatment with hydroxocobalamin, leading to resolution of her cyanide toxicity...
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/28757637/intravenous-hydroxocobalamin-and-crystal-nephropathy
#17
Matthieu Legrand, Vincent Mallet
No abstract text is available yet for this article.
September 2017: Nature Reviews. Nephrology
https://www.readbyqxmd.com/read/28676841/an-in-vitro-model-of-gastric-inflammation-and-treatment-with-cobalamin
#18
T R Elliott, A L Guildford
Pernicious anaemia (PA) is an autoimmune condition where antibodies target intrinsic factor and parietal cells, reducing the patient's ability to absorb cobalamin promoting atrophic gastritis. Treatment guidelines are based on excretion data of hydroxocobalamin from healthy individuals obtained 50 years ago. This manuscript describes the use of phorbol 12-myristate 13-acetate (PMA) to stimulate low grade inflammation in an epithelial colorectal cell line to assess the efficacy of methylcobalamin and hydroxocobalamin...
2017: International Journal of Inflammation
https://www.readbyqxmd.com/read/28644688/intraosseous-administration-of-antidotes-a-systematic-review
#19
Audrée Elliott, Pierre-André Dubé, Amélie Cossette-Côté, Laura Patakfalvi, Eric Villeneuve, Martin Morris, Sophie Gosselin
CONTEXT: Intraosseous (IO) access is an established route of administration in resuscitation situations. Patients with serious poisoning presenting to the emergency department may require urgent antidote therapy. However, intravenous (IV) access is not always readily available. OBJECTIVE: This study reviews the current evidence for IO administration of antidotes that could be used in poisoning. The primary outcome was mortality as a surrogate of efficacy. Secondary outcomes included hemodynamic variables, electrocardiographic variables, neurological status, pharmacokinetics outcomes, and adverse effects as defined by each article...
June 23, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28625450/vasoplegic-syndrome-an-update-on-perioperative-considerations
#20
REVIEW
Henry Liu, Ling Yu, Longqiu Yang, Michael S Green
Vasoplegic syndrome (VS) is increasingly recognized as an important clinical entity in perioperative medicine. VS is characterized by significant arterial hypotension, normal or high cardiac output, low systemic vascular resistance, and increased requirements for intravenous volume and vasopressors. Tremendous variations exist regarding incidence reported in the literature and management at different institutions; and the incidence of VS is likely significantly higher than many anesthesiologists believe. Thus the aims of this article are to review the pertinent aspects related to VS and alert clinical anesthesiologists to this under-recognized yet very challenging clinical condition...
August 2017: Journal of Clinical Anesthesia
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