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https://www.readbyqxmd.com/read/27880060/neurogenic-pulmonary-oedema-complicating-traumatic-posterior-fossa-extradural-haematoma-case-report-and-review
#1
Ajay Hegde, G Lakshmi Prasad, Priyanka Kini
INTRODUCTION: Pulmonary oedema is accumulation of fluid in the lung air spaces and interstitia. Neurogenic pulmonary oedema (NPE) is a potentially life-threatening condition which has been noted in head injury, subarachnoid haemorrhage (SAH), intracerebral haemorrhage (ICH) and others. Timely management is crucial to achieve good outcome; however, no specific guidelines have been defined. METHODS: A 33-year female involved in a motor vehicular accident had a GCS of 14/15 and CT scan showed a moderate-sized unilateral posterior fossa extradural haematoma (PFEDH)...
November 23, 2016: Brain Injury: [BI]
https://www.readbyqxmd.com/read/27858465/established-and-novel-treatment-options-in-acute-myocarditis-with-or-without-heart-failure
#2
George Lazaros, Evangelos Oikonomou, Dimitris Tousoulis
Acute myocarditis is a disorder characterized by an unpredictable clinical course which ranges from asymptomatic, incidentally discovered forms, to cases with fulminant course and adverse outcome. The most challenging issues in the context of acute myocarditis are the appearance of difficult to treat heart failure in the acute phase and the potential progression in the long-term to dilated cardiomyopathy. Areas covered: With respect to available treatment options in acute myocarditis, in the absence of specific guidelines, management is supportive and overall empirical, especially for the oligo- or asymptomatic patients with preserved ejection fraction...
November 23, 2016: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/27848906/-attempted-suicide-with-barbiturates-purchased-online
#3
S F Chavoushi, L Mesman, P G Noordzij, M A Sikma, E M van Maarseveen
BACKGROUND: Barbiturate intoxication is potentially lethal. With the availability of the newer anticonvulsants the use of barbiturates in treating epilepsy has decreased significantly, with a concurrent decrease in the incidence of overdose with these medications. There have, however, been recent alarm signals from governmental sources concerning the increase in the Internet purchase of illegal medications, including barbiturates, for use in attempted suicide. CASE DESCRIPTION: Here we describe two patient cases involving barbiturate intoxication with amobarbital and thiopental, respectively...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27813339/metabolic-support-for-the-heart-complementary-therapy-for-heart-failure
#4
REVIEW
Ward A Heggermont, Anna-Pia Papageorgiou, Stephane Heymans, Marc van Bilsen
The failing heart has an increased metabolic demand and at the same time suffers from impaired energy efficiency, which is a detrimental combination. Therefore, therapies targeting the energy-deprived failing heart and rewiring cardiac metabolism are of great potential, but are lacking in daily clinical practice. Metabolic impairment in heart failure patients has been well characterized for patients with reduced ejection fraction, and is coming of age in patients with 'preserved' ejection fraction. Targeting cardiomyocyte metabolism in heart failure could complement current heart failure treatments that do improve cardiovascular haemodynamics, but not the energetic status of the heart...
December 2016: European Journal of Heart Failure
https://www.readbyqxmd.com/read/27797797/infrarenal-aortic-clamp-reviving-a-patient-from-acute-surgical-haemorrhagic-shock-a-novel-management-technique
#5
Ranjith Kumar, M V S Satya Prakash, Subhasree Das, Ramanitharan Manikandan
Surgical management of renal cell carcinoma extending into the inferior vena cava (IVC) is almost always accompanied by massive intraoperative blood loss and associated complications. It is a widely recognised problem, and its active management is essential in improving the perioperative morbidity and mortality. We share our experience with a similar case of open radical nephrectomy with massive blood loss of twice the circulating volume in a duration of <8 surgical hours. Although we emphasise the goals of securing haemostasis, restoration of circulating volume, and efficient management by replacing blood components, in the present case, despite the above-mentioned goals being fulfilled, we were unable to extricate the patient from haemorrhagic shock by conventional means and therefore resorted to desperate measures, namely the novel approach of infrarenal aortic clamping along with higher than recommended vasopressor support...
October 19, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27726292/rapid-pacing-using-the-0-035-in-retrograde-left-ventricular-support-wire-in-208-cases-of-transcatheter-aortic-valve-implantation-and-balloon-aortic-valvuloplasty
#6
Roland Hilling-Smith, James Cockburn, Maureen Dooley, Jessica Parker, Andrea Newton, Andrew Hill, Uday Trivedi, Adam de Belder, David Hildick-Smith
: Transcatheter aortic valve implantation (TAVI) and balloon aortic valvuloplasty (BAV) are now well established percutaneous procedures. These procedures almost always require bursts of rapid ventricular pacing to temporarily reduce cardiac output to facilitate the procedure, usually done via a temporary pacing wire inserted into the right ventricle. We describe a case series of 132 cases of TAVI and 76 BAV done using ventricular pacing via the left ventricular lead by simply connecting one electrode to the patient's skin and one electrode through the left ventricular (LV) wire...
October 11, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27680819/h3-maternal-haedomynamics-in-hypertensive-disorders-of-pregnancy-a-case-control-study
#7
D Vinayagam, Elena Mantovani, B Thilaganthan, A Khalil
BACKGROUND: Hypertensive disorders in pregnancy (HDP) are associated with altered maternal haemodynamics, which can be investigated using non-invasive methodologies. OBJECTIVE: To assess maternal haemodynamics using USCOM 1A® in patients presenting with non-medicated, hypertensive disorders of pregnancy and normotensive controls. METHODS: A prospective, nested case-control study in 65 patients presenting with unmedicated hypertension. The control population consisted of 400 subjects who did not have a history of hypertensive disorders...
August 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27660252/sepsis-and-septic-shock-is-a-microcirculation-a-main-player
#8
Małgorzata Lipinska-Gediga
Shock, defined at a cellular level, is a condition in which oxygen delivery to the cells is not sufficient to sustain cellular activity and support organ function. The central role of microcirculation in providing oxygen to the cells makes it of prime importance in determining organ function. In sepsis and septic shock, macrocirculatory alterations and microcirculatory dysfunction participate concurrently in the pathophysiology of organ failure. Haemodynamic coherence in shock is a condition in which normalization of systemic haemodynamic variables results in simultaneous amelioration in the perfusion of the microcirculation and restoration of tissue oxygenation as a final result...
September 23, 2016: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/27640031/patient-selection-for-tavi-in-2016-should-we-break-through-the-low-risk-barrier
#9
Mohammad Abdelghani, Patrick W Serruys
The earliest evidence supporting transcatheter aortic valve implantation (TAVI) was derived from its comparison with conservative therapy in inoperable patients and with surgical aortic valve replacement (SAVR) in extremely high risk patients. TAVI had a relative advantage in these situations being less invasive and hence less prone to the classic early postoperative devastating complications. To prove as effective in less fragile and less morbid patients, the long-term durability of the haemodynamic and clinical gains from TAVI needs to be confirmed...
September 18, 2016: EuroIntervention
https://www.readbyqxmd.com/read/27628296/feasibility-and-utility-of-portable-ultrasound-during-retrieval-of-sick-term-and-late-preterm-infants
#10
Kathryn Browning Carmo, Tracey Lutz, Andrew Berry, Martin Kluckow, Nick Evans
AIM: To determine the role of clinician performed ultrasound (CPU) during the retrieval and transport of critically ill term and near term newborns. METHODS: A neonatologist with portable ultrasound accompanied a sample of newborn retrievals to perform cardiac and cerebral ultrasound before and after transportation. RESULTS: A total of fifty-five babies were studied. Median birthweight: 3350 g (2220-5030 g). CPU led to a change in the planned receiving hospital in ten babies...
December 2016: Acta Paediatrica
https://www.readbyqxmd.com/read/27620314/a-review-of-the-evidence-to-support-neuromuscular-electrical-stimulation-in-the-prevention-and-management-of-venous-disease
#11
K J Williams, R Ravikumar, A S Gaweesh, H M Moore, A D Lifsitz, T R A Lane, J Shalhoub, A Babber, A H Davies
INTRODUCTION: The prevention and management of venous disease is a therapeutic challenge. Movement of blood through the venous system is augmented by the action of muscles on the deep veins, and can be achieved through the application of electrical current. The efficacy of currently available clinical devices for this purpose is unknown, and is investigated here. METHODS: A literature search of the EMBASE and Medline databases was performed, and studies were included if they were full text articles, written in english, pertaining to venous disease and neuromuscular electrical stimulation (NMES)...
September 13, 2016: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/27618183/different-respiratory-rates-during-resuscitation-in-a-pediatric-animal-model-of-asphyxial-cardiac-arrest
#12
Jorge López, Sarah N Fernández, Rafael González, María J Solana, Javier Urbano, Jesús López-Herce
AIMS: Actual resuscitation guidelines recommend 10 respirations per minute (rpm) for advanced pediatric life support. This respiratory rate (RR) is much lower than what is physiological for children. The aim of this study is to compare changes in ventilation, oxygenation, haemodynamics and return of spontaneous circulation (ROSC) rates with three RR. METHODS: An experimental model of asphyxial cardiac arrest (CA) in 46 piglets (around 9.5 kg) was performed. Resuscitation with three different RR (10, 20 and 30 rpm) was carried out...
2016: PloS One
https://www.readbyqxmd.com/read/27617754/the-value-of-carina-angle-measurement-for-the-diagnosis-of-patent-ductus-arteriosus
#13
K Karaman, S Karaman, A Üner, I Ece
Objectives: We aimed to assess whether the widened carina angle displayed on X-ray supports the presumptive presence of patent ductus arteriosus. Methods: The study group was arranged by 60 infants under 37 weeks diagnosed with haemodynamically significant patent ductus arteriosus. The control group was constituted by 60 infants with no clinical or echocardiographic evidence of patent ductus arteriosus. In both groups, the location of the left main bronchus was assessed by measuring the angle between two main bronchi at the level of carina...
January 8, 2016: West Indian Medical Journal
https://www.readbyqxmd.com/read/27608344/the-alfred-hospital-experience-of-resumption-of-cardiac-activity-after-withdrawal-of-life-sustaining-therapy
#14
S A Yong, S D'Souza, S Philpot, D V Pilcher
With the advent of donation after circulatory death programs in Australia and New Zealand, greater knowledge is needed about physiologic variation in haemodynamic activity following withdrawal of cardiorespiratory support. The ANZICS Statement on Death and Organ Donation allows provision for variation in the observation times between two and five minutes after cessation of the circulation prior to declaration of death. We report our experience of two cases, the first where electrical activity and pulse returned after a 102 second pause and the second where electrical activity returned after a three minute pause; both longer than previously reported cases...
September 2016: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/27604617/12th-winfocus-world-congress-on-ultrasound-in-emergency-and-critical-care
#15
Yahya Acar, Onur Tezel, Necati Salman, Erdem Cevik, Margarita Algaba-Montes, Alberto Oviedo-García, Mayra Patricio-Bordomás, Mustafa Z Mahmoud, Abdelmoneim Sulieman, Abbas Ali, Alrayah Mustafa, Ihab Abdelrahman, Mustafa Bahar, Osama Ali, H Lester Kirchner, Gregor Prosen, Ajda Anzic, Paul Leeson, Maryam Bahreini, Fatemeh Rasooli, Houman Hosseinnejad, Gabriel Blecher, Robert Meek, Diana Egerton-Warburton, Edina Ćatić Ćuti, Stanko Belina, Tihomir Vančina, Idriz Kovačević, Nadan Rustemović, Ikwan Chang, Jin Hee Lee, Young Ho Kwak, Do Kyun Kim, Chi-Yung Cheng, Hsiu-Yung Pan, Chia-Te Kung, Ela Ćurčić, Ena Pritišanac, Ivo Planinc, Marijana Grgić Medić, Radovan Radonić, Abiola Fasina, Anthony J Dean, Nova L Panebianco, Patricia S Henwood, Oliviero Fochi, Moreno Favarato, Ezio Bonanomi, Ivan Tomić, Youngrock Ha, Hongchuen Toh, Elizabeth Harmon, Wilma Chan, Cameron Baston, Gail Morrison, Frances Shofer, Angela Hua, Sharon Kim, James Tsung, Isa Gunaydin, Zeynep Kekec, Mehmet Oguzhan Ay, Jinjoo Kim, Jinhyun Kim, Gyoosung Choi, Dowon Shim, Ji-Han Lee, Jana Ambrozic, Katja Prokselj, Miha Lucovnik, Gabrijela Brzan Simenc, Asta Mačiulienė, Almantas Maleckas, Algimantas Kriščiukaitis, Vytautas Mačiulis, Andrius Macas, Sharad Mohite, Zoltan Narancsik, Hugon Možina, Sara Nikolić, Jan Hansel, Rok Petrovčič, Una Mršić, Simon Orlob, Markus Lerchbaumer, Niklas Schönegger, Reinhard Kaufmann, Chun-I Pan, Chien-Hung Wu, Sarah Pasquale, Stephanie J Doniger, Sharon Yellin, Gerardo Chiricolo, Maja Potisek, Borut Drnovšek, Boštjan Leskovar, Kristine Robinson, Clara Kraft, Benjamin Moser, Stephen Davis, Shelley Layman, Yusef Sayeed, Joseph Minardi, Irmina Sefic Pasic, Amra Dzananovic, Anes Pasic, Sandra Vegar Zubovic, Ana Godan Hauptman, Ana Vujaklija Brajkovic, Jaksa Babel, Marina Peklic, Vedran Radonic, Luka Bielen, Peh Wee Ming, Nur Hafiza Yezid, Fatahul Laham Mohammed, Zainal Abidin Huda, Wan Nasarudin Wan Ismail, W Yus Haniff W Isa, Hashairi Fauzi, Praveena Seeva, Mohd Zulfakar Mazlan
A1 Point-of-care ultrasound examination of cervical spine in emergency departmentYahya Acar, Onur Tezel, Necati SalmanA2 A new technique in verifying the placement of a nasogastric tube: obtaining the longitudinal view of nasogastric tube in addition to transverse view with ultrasoundYahya Acar, Necati Salman, Onur Tezel, Erdem CevikA3 Pseudoaneurysm of the femoral artery after cannulation of a central venous line. Should we always use ultrasound in these procedures?Margarita Algaba-Montes, Alberto Oviedo-García, Mayra Patricio-BordomásA4 Ultrasound-guided supraclavicular subclavian vein catheterization...
September 2016: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/27567896/severe-community-acquired-pneumonia-timely-management-measures-in-the-first-24-hours
#16
REVIEW
Jason Phua, Nathan C Dean, Qi Guo, Win Sen Kuan, Hui Fang Lim, Tow Keang Lim
Mortality rates for severe community-acquired pneumonia (CAP) range from 17 to 48 % in published studies.In this review, we searched PubMed for relevant papers published between 1981 and June 2016 and relevant files. We explored how early and aggressive management measures, implemented within 24 hours of recognition of severe CAP and carried out both in the emergency department and in the ICU, decrease mortality in severe CAP.These measures begin with the use of severity assessment tools and the application of care bundles via clinical decision support tools...
August 28, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27529179/haemodynamic-transition-after-birth-a-new-tool-for-non-invasive-cardiac-output-monitoring
#17
Thomas Freidl, Nariae Baik, Gerhard Pichler, Bernhard Schwaberger, Barbara Zingerle, Alexander Avian, Berndt Urlesberger
BACKGROUND: Substantial haemodynamic changes occur during the first minutes after birth. Currently, only heart rate (HR) and arterial oxygen saturation are routinely used to monitor haemodynamic transition after birth. OBJECTIVES: The aim of the present study was to continuously assess haemodynamic changes during transition in term infants for the first time by using electrical velocimetry (EV), a new method of non-invasive cardiac output monitoring (NICOM), based on impedance cardiography technology...
August 17, 2016: Neonatology
https://www.readbyqxmd.com/read/27508638/-op-2d-03-pulsatile-stretch-alters-expression-and-processing-of-amyloid-precursor-protein-in-human-cerebral-endothelial-cells
#18
S V S Gangoda, M Butlin, V Gupta, R Chung, A Avolio
OBJECTIVE: Amyloid β (Aβ) deposition is a hallmark of Alzheimer's disease (AD). Aβ is generated via enzymatic cleavage of amyloid precursor protein (APP). Increased APP expression is associated with elevated amyloid burden. Elevated pulsatility of arterial pressure, as a vascular factor indicative of vascular stiffness, is associated with AD. This study investigates whether increased magnitude of pulsatile stretch of human cerebral microvascular endothelial cells (hCMEC) alters expression and processing of APP...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27467730/haemodynamic-assessment-of-human-coronary-arteries-is-affected-by-degree-of-freedom-of-artery-movement
#19
Ashkan Javadzadegan, Andy S C Yong, Michael Chang, Martin K C Ng, Masud Behnia, Leonard Kritharides
: Abnormal haemodynamic parameters are associated with atheroma plaque progression and instability in coronary arteries. Flow recirculation, shear stress and pressure gradient are understood to be important pathogenic mediators in coronary disease. The effect of freedom of coronary artery movement on these parameters is still unknown. Fluid-structure interaction (FSI) simulations were carried out in 25 coronary artery models derived from authentic human coronaries in order to investigate the effect of degree of freedom of movement of the coronary arteries on flow recirculation, wall shear stress (WSS) and wall pressure gradient (WPG)...
July 28, 2016: Computer Methods in Biomechanics and Biomedical Engineering
https://www.readbyqxmd.com/read/27456327/effectiveness-and-safety-of-treatments-used-for-the-management-of-patent-ductus-arteriosus-pda-in-preterm-infants-a-protocol-for-a-systematic-review-and-network-meta-analysis
#20
Souvik Mitra, Ivan D Florez, Maria E Tamayo, Dagfinn Aune, Lawrence Mbuagbaw, Areti-Angeliki Veroniki, Lehana Thabane
INTRODUCTION: Management of patent ductus arteriosus (PDA) in preterm infants is one of the most controversial topics in neonatal medicine. The availability of different pharmacotherapeutic options often poses a practical challenge to the practising neonatologist as to which one to choose as a therapeutic option. Our objectives are to determine the relative merits of the available pharmacotherapeutic options for the management of PDA. METHODS AND ANALYSIS: We will conduct a systematic review of all randomised controlled trials evaluating the use of intravenous or oral: indomethacin, ibuprofen and acetaminophen for the treatment of PDA in preterm infants...
July 25, 2016: BMJ Open
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