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Intravenous fluids

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https://www.readbyqxmd.com/read/29151001/intravenous-fluid-therapy-for-hospitalized-and-critically-ill-children-rationale-available-drugs-and-possible-side-effects
#1
Thomas Langer, Rosamaria Limuti, Concezione Tommasino, Niels van Regenmortel, Els L I M Duval, Pietro Caironi, Manu L N G Malbrain, Antonio Pesenti
Human beings are constituted mainly of water. In particular, children's total body water might reach 75-80% of their body weight, compared to 60-70% in adults. It is therefore not surprising, that children, especially hospitalized newborns and infants, are markedly prone to water and electrolyte imbalances. Parenteral fluid therapy is a cornerstone of medical treatment and is thus of exceptional relevance in this patient population. It is crucial to appreciate the fact that intravenous fluids are drugs with very different characteristics, different indications, contraindications and relevant side effects...
November 18, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29148196/umbilicus-and-its-extensive-clinical-repertoire
#2
Spencer W Beasley
The umbilicus is involved in a wide range of abnormalities in infants and children. The most severe are evident at birth and include exomphalos (omphalocele) and gastroschisis, both of which can be life-threatening but are easy to diagnose. Exomphalos is often associated with other congenital abnormalities, whereas the associated problems in gastroschisis are largely confined to the gut. Infection of the umbilicus in the neonate presents as omphalitis. The causes of a moist umbilicus following separation of the umbilical stump are multiple, from the relatively minor umbilical granuloma or ectopic bowel mucosa to the more significant patent urachus that leaks urine...
November 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/29148174/prehospital-transfusion-of-red-cell-concentrates-in-a-paramedic-staffed-helicopter-emergency-medical-service
#3
Stefan Heschl, Emily Andrew, Anthony de Wit, Stephen Bernard, Marcus Kennedy, Karen Smith
OBJECTIVE: The optimal volume and type of intravenous fluid for the treatment of blood loss in the prehospital setting is controversial. The use of red cell concentrates (RCCs) may be associated with improved outcomes; however, the administration of blood products is limited to physicians in many jurisdictions. We sought to describe the characteristics of RCC transfusions in a paramedic-staffed helicopter emergency medical system in Victoria, Australia. METHODS: We performed a retrospective analysis of all cases where paramedics consulted the responsible physician for approval of RCC transfusion between July 2011 and December 2015 in Victoria, Australia...
November 17, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29145467/adenosine-lidocaine-and-mg2-alm-fluid-therapy-attenuates-systemic-inflammation-platelet-dysfunction-and-coagulopathy-after-non-compressible-truncal-hemorrhage
#4
Hayley Letson, Geoffrey Dobson
BACKGROUND: Systemic inflammation and coagulopathy are major drivers of injury progression following hemorrhagic trauma. Our aim was to examine the effect of small-volume 3% NaCl adenosine, lidocaine and Mg2+ (ALM) bolus and 0.9% NaCl/ALM 'drip' on inflammation and coagulation in a rat model of hemorrhagic shock. METHODS: Sprague-Dawley rats (429±4 g) were randomly assigned to: 1) shams, 2) no-treatment, 3) saline-controls, 4) ALM-therapy, and 5) Hextend®. Hemorrhage was induced in anesthetized-ventilated animals by liver resection (60% left lateral lobe and 50% medial lobe)...
2017: PloS One
https://www.readbyqxmd.com/read/29142382/capillary-leak-syndrome-following-snakebite-envenomation
#5
REVIEW
V Udayabhaskaran, E T Arun Thomas, Bhagya Shaji
Capillary leak syndrome is a unique complication that follows Russell's viper envenomation. This syndrome has a very high fatality rate and is characterized by parotid swelling, chemosis, periorbital edema, hypotension, albuminuria, hypoalbuminemia, and hemoconcentration. This syndrome is frequently recognized from the southern parts of India, especially from the state of Kerala. It has been postulated that a vascular apoptosis inducing component of Russell's viper venom that is not neutralized by the commercially available anti-snake venom (ASV) is responsible for this complication as it occurs even after adequate doses of ASV administration in most cases...
October 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29142152/indirect-proton-mr-imaging-and-kinetic-analysis-of-17-o-labeled-water-tracer-in-the-brain
#6
Kohsuke Kudo, Taisuke Harada, Hiroyuki Kameda, Ikuko Uwano, Fumio Yamashita, Satomi Higuchi, Kunihiro Yoshioka, Makoto Sasaki
PURPOSE: The feasibility of steady-state sequences for (17)O imaging was evaluated based on a kinetic analysis of the brain parenchyma and cerebrospinal fluid (CSF). MATERIALS AND METHODS: The institutional review board approved this prospective study with written informed consent. Dynamic 2D or 3D steady-state sequences were performed in five and nine participants, respectively, with different parameters using a 3T scanner. During two consecutive dynamic scans, saline was intravenously administered for control purposes in the first scan, and 20% (17)O-labeled water (1 mL/Kg) was administered in the second scan...
November 16, 2017: Magnetic Resonance in Medical Sciences: MRMS
https://www.readbyqxmd.com/read/29142147/accidental-afloqualone-intoxication-in-two-dogs
#7
Jin-Ok Ahn, Won-Joung Jaung, Sang-Heum Won, Min-Ok Ryu, Woo-Jin Song, Kee-Ok Jeon, Jin-Young Chung, Hwa-Young Youn
Two dogs presented to the emergency service after accidental ingestion of afloqualone tablets, a muscle relaxant used for back pain in humans. Toxic effects of the drug in these dogs included vomiting, respiratory depression, seizures, ataxia, bradycardia, and hematuria. Treatment consisted of fluid diuresis, furosemide, and propofol. Flumazenil, a gamma-amino butyric acid antagonist, was administered intravenously; however, it was not effective in stopping the seizures in these dogs. Both dogs recovered with supportive treatment...
November 14, 2017: Journal of Veterinary Medical Science
https://www.readbyqxmd.com/read/29140948/hypertonic-saline-resuscitation-following-emergent-laparotomy-and-temporary-abdominal-closure
#8
Tyler J Loftus, Philip A Efron, Trina M Bala, Martin D Rosenthal, Chasen A Croft, R Stephen Smith, Frederick A Moore, Alicia M Mohr, Scott C Brakenridge
BACKGROUND: Our objective was to establish the safety of 3% hypertonic saline (HTS) resuscitation for trauma and acute care surgery patients undergoing emergent laparotomy and temporary abdominal closure (TAC) with the hypothesis that HTS administration would be associated with hyperosmolar hypercholoremic acidosis, lower resuscitation volumes, and higher fascial closure rates, without adversely affecting renal function. METHODS: We performed a retrospective cohort analysis of 189 trauma and acute care surgery patients who underwent emergent laparotomy and TAC, comparing patients with normal baseline renal function who received 3% HTS at 30 mL/h (n=36) to patients with standard resuscitation (n=153) by baseline characteristics, resuscitation parameters, and outcomes including primary fascial closure and KDIGO stages of acute kidney injury...
November 14, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29136715/-analysis-of-the-clinical-and-electrophysiological-characteristics-of-multifocal-motor-neuropathy
#9
H F Wang, F Yang, F Cui, Z H Chen, L Ling, X S Huang
Ten patients diagnosed with multifocal motor neuropathy (MMN) were recruited in the Department of Neurology at Chinese PLA General Hospital from January 1, 2009 to August 31, 2015. The clinical and electrophysiological features were analyzed retrospectively. All patients complained of progressive asymmetric limb weakness, which was more severe in distal than in proximal. Five presented muscle atrophy. None had sensory disturbances. All suffered diminished or disappeared tendon reflex, whereas Babinski signs were negative...
November 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/29135900/ondansetron-prescription-for-home-use-in-a-pediatric-emergency-department
#10
James M Gray, Jaya D Maewal, Scott A Lunos, Ronald A Furnival, Marissa A Hendrickson
OBJECTIVES: Ondansetron has been shown to decrease admission rates and the need for intravenous fluids among pediatric emergency department (ED) patients with acute gastroenteritis, but there is limited evidence regarding its use after ED discharge. This study describes prescribing patterns for ondansetron and assesses the effects of ondansetron home prescription on rate of return. METHODS: Data were gathered from the electronic health record on 2 separate but overlapping groups of patients seen in a pediatric ED from 2012 to 2014...
November 14, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29132978/intensive-care-in-severe-malaria-report-from-the-task-force-on-tropical-diseases-by-the-world-federation-of-societies-of-intensive-and-critical-care-medicine
#11
REVIEW
Dilip R Karnad, Mohd Basri Mat Nor, Guy A Richards, Tim Baker, Pravin Amin
Severe malaria is common in tropical countries in Africa, Asia, Oceania and South and Central America. It may also occur in travelers returning from endemic areas. Plasmodium falciparum accounts for most cases, although P vivax is increasingly found to cause severe malaria in Asia. Cerebral malaria is common in children in Africa, manifests as coma and seizures, and has a high morbidity and mortality. In other regions, adults may also develop cerebral malaria but neurological sequelae in survivors are rare...
November 8, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29132842/-a-comparison-of-post-surgical-plasma-glucose-levels-in-patients-on-fluids-with-different-glucose-concentrations
#12
Isabel Martínez Carapeto, José Domingo López Castilla, Reyes Fresneda Gutiérrez
OBJECTIVE: To compare plasma glucose levels and incidence of hyperglycaemia in the post-operative period after general surgery using fluids with different glucose. METHODOLOGY: A randomised, open-label, non-blind, clinical trial was conducted on patients admitted to Paediatric Intensive Care Unit after elective surgery. The inclusion criteria were from 6 months to 14 years of age, with a weight greater than 6kg, onset glucose level >60mg/dL, and a signed informed consent, with no oral intake and maintenance intravenous fluid therapy using fluids with 3...
November 11, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/29132771/-neonatal-herpes-epidemiology-clinical-manifestations-and-management-guidelines-for-clinical-practice-from-the-french-college-of-gynecologists-and-obstetricians-cngof
#13
L Renesme
OBJECTIVES: To describe the epidemiology of neonatal herpes and its risk factors, clinical and paraclinic manifestations, propose guidelines for a newborn at risk of neonatal herpes, describe treatment modalities, describe post-natal transmission and its prevention. METHODS: Bibliographic search from Medline, Cochrane Library databases and research of international clinical practice guidelines. RESULTS: Neonatal herpes is rare (about 20 cases per year in France) and mainly due to HSV 1 (level of evidence LE3)...
November 10, 2017: Gynecologie, Obstetrique, Fertilite & Senologie
https://www.readbyqxmd.com/read/29132768/pr%C3%A3-vention-et-prise-en-charge-de-l%C3%A2-infection-herp%C3%A3-tique-au-cours-de-la-grossesse-et-de-l%C3%A2-accouchement%C3%A2-recommandations-pour-la-pratique-clinique-%C3%A2-%C3%A2-texte-des-recommandations-texte-court
#14
M-V Sénat, O Anselem, O Picone, L Renesme, N Sananès, C Vauloup-Fellous, Y Sellier, J-P Laplace, L Sentilhes
OBJECTIVE: Identify measures to diagnose, prevent and treat genital herpes infection during pregnancy and childbirth and neonatal infection. METHODS: Bibliographic search from Medline, Cochrane Library databases and research of international clinical practice guidelines. RESULTS: Genital herpes lesion is most often due to HSV2 (LE2). The risk of HSV seroconversion during pregnancy is 1 to 5% (LE2). Genital herpes ulceration during pregnancy in a woman with history of genital herpes corresponds with a recurrence...
November 10, 2017: Gynecologie, Obstetrique, Fertilite & Senologie
https://www.readbyqxmd.com/read/29132521/gallbladder-dysfunction-cholecystitis-choledocholithiasis-cholangitis-and-biliary-dyskinesia
#15
REVIEW
Thad Wilkins, Edward Agabin, Jason Varghese, Asif Talukder
The prevalence of gallstones is 10% to 15% in adults. Individuals with acute cholecystitis present with right upper quadrant pain, fever, and leukocytosis. Management includes supportive care and cholecystectomy. The prevalence of choledocholithiasis is 10% to 20%, and serious complications include cholangitis and gallstone pancreatitis. The goal of management in individuals with choledocholithiasis consists of clearing common bile duct stones. Acute ascending cholangitis is a life-threatening condition involving acute inflammation and infection of the common bile duct...
December 2017: Primary Care
https://www.readbyqxmd.com/read/29128964/in-vivo-assessment-of-a-novel-biodegradable-ureteral-stent
#16
Alexandre A Barros, Carlos Oliveira, Ana J Ribeiro, Riccardo Autorino, Rui L Reis, Ana Rita C Duarte, Estevão Lima
PURPOSE: To perform an in vivo assessment of a newly developed biodegradable ureteral stent (BUS) produced with natural-based polymers. METHODS: The BUS is based on a patented technology combining the injection process with the use of supercritical fluid technology. Study was conducted at ICVS-University of Minho (Braga, Portugal) and a total of ten domestic pigs were used. In seven animals, the experimental BUS stent was inserted, whereas in the remaining a commercially available stent was used (6-Fr Biosoft(®) duo stents, Porges Coloplast, Denmark)...
November 11, 2017: World Journal of Urology
https://www.readbyqxmd.com/read/29125999/preclinical-evaluation-of-heat-denatured-18-f-fdg-labeled-red-blood-cells-for-detecting-splenic-tissues-with-pet-in-rats
#17
Yohji Matsusaka, Tadaki Nakahara, Kazuhiro Takahashi, Yu Iwabuchi, Yuji Ogata, Chiyoko Nishime, Mayumi Kajimura, Masahiro Jinzaki
INTRODUCTION: Heat-denatured (99m)Tc-labeled red blood cells (RBCs) are used for detecting splenic tissues with scintigraphy. The present study aimed to evaluate the feasibility of using heat-denatured [(18)F]fluorodeoxyglucose ([(18)F]FDG)-labeled RBCs in detecting splenic tissues using positron emission tomography (PET) in rats. METHODS: RBCs were washed with phosphate buffered saline, labeled with [(18)F]FDG at 38°C, and heat-denatured at 50°C for 15 min. In vitro stability was assessed by measuring extracellular radioactivity during the 0-180 min incubation at 37°C...
September 18, 2017: Nuclear Medicine and Biology
https://www.readbyqxmd.com/read/29125625/low-inherent-sensitivity-to-the-intoxicating-effects-of-ethanol-in-rhesus-monkeys-with-low-csf-concentrations-of-the-serotonin-metabolite-5-hydroxyindoleacetic-acid
#18
Elizabeth K Wood, Ryno Kruger, Angus Bennion, Bradley M Cooke, Stephen Lindell, Melanie Schwandt, David Goldman, Christina S Barr, Stephen J Suomi, J Dee Higley
INTRODUCTION: Type 2 Alcoholism is characterized by low serotonin system functioning and has a high degree of heritability, with offspring of alcoholics often showing a reduced response to the intoxicating effects of ethanol, which is thought to be marker for future alcohol use disorders (AUDs). As such, an important aim of studies investigating the origins of AUDs is understanding the relationship between serotonin system functioning and level of intoxication. A nonhuman primate model was used to evaluate observational ratings of sensitivity to ethanol and to further investigate the relationship between central serotonin activity and behavioral response to ethanol...
November 10, 2017: Alcoholism, Clinical and Experimental Research
https://www.readbyqxmd.com/read/29123436/development-and-retrospective-clinical-assessment-of-a-patient-specific-closed-form-integro-differential-equation-model-of-plasma-dilution
#19
Glen Atlas, John K-J Li, Shawn Amin, Robert G Hahn
A closed-form integro-differential equation (IDE) model of plasma dilution (PD) has been derived which represents both the intravenous (IV) infusion of crystalloid and the postinfusion period. Specifically, PD is mathematically represented using a combination of constant ratio, differential, and integral components. Furthermore, this model has successfully been applied to preexisting data, from a prior human study, in which crystalloid was infused for a period of 30 minutes at the beginning of thyroid surgery...
2017: Biomedical Engineering and Computational Biology
https://www.readbyqxmd.com/read/29123419/encephalitis-treatment-a-case-report-with-long-term-follow-up-of-ebv-pcr-in-cerebrospinal-fluid
#20
Fnu Zarlasht, Mashal Salehi, Mohammad Abu-Hishmeh, Muzammil Khan
Background: Epstein-Barr virus (EBV) has been found to cause infectious mononucleosis multiple times, but has been associated rarely with EBV encephalitis. Also, whenever it is diagnosed, it is always treated symptomatically. Case report: A case of confirmed EBV encephalitis is presented, which was treated with antiviral therapy resulting in complete clearance of the virus in cerebrospinal fluid and minimal neurologic symptoms after hospital discharge. Conclusion: The Infectious Diseases Society of America guidelines state that intravenous acyclovir is not recommended for EBV-related encephalitis...
2017: International Journal of General Medicine
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