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https://www.readbyqxmd.com/read/28101446/hypertonicity-clinical-entities-manifestations-and-treatment
#1
REVIEW
Helbert Rondon-Berrios, Christos Argyropoulos, Todd S Ing, Dominic S Raj, Deepak Malhotra, Emmanuel I Agaba, Mark Rohrscheib, Zeid J Khitan, Glen H Murata, Joseph I Shapiro, Antonios H Tzamaloukas
Hypertonicity causes severe clinical manifestations and is associated with mortality and severe short-term and long-term neurological sequelae. The main clinical syndromes of hypertonicity are hypernatremia and hyperglycemia. Hypernatremia results from relative excess of body sodium over body water. Loss of water in excess of intake, gain of sodium salts in excess of losses or a combination of the two are the main mechanisms of hypernatremia. Hypernatremia can be hypervolemic, euvolemic or hypovolemic. The management of hypernatremia addresses both a quantitative replacement of water and, if present, sodium deficit, and correction of the underlying pathophysiologic process that led to hypernatremia...
January 6, 2017: World Journal of Nephrology
https://www.readbyqxmd.com/read/28100471/valve-thrombosis-following-transcatheter-aortic-valve-replacement-significance-of-blood-stasis-on-the-leaflets
#2
Koohyar Vahidkhah, Mohammed Barakat, Mostafa Abbasi, Shahnaz Javani, Peyman N Azadani, Anwar Tandar, Danny Dvir, Ali N Azadani
OBJECTIVES: Leaflet thrombosis following transcatheter aortic valve replacement (TAVR) and valve-in-valve (ViV) procedures has been increasingly recognized. However, the factors affecting the post-TAVR/ViV thrombosis are not fully understood. This study aimed to investigate the effect of the geometric confinement of transcatheter aortic valve (TAV) on blood residence time (BRT) on the TAV leaflets and in turn on the post-TAVR valve thrombosis. METHODS: Two computational models, representing a surgical bioprosthesis and a TAV, were developed to study the effect of the geometric confinement on BRT on the leaflets in ViV setting/TAVR Intra-annular positioning...
January 17, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28099643/balanced-crystalloids-for-septic-shock-resuscitation
#3
Thiago Domingos Corrêa, Alexandre Biasi Cavalcanti, Murillo Santucci Cesar de Assunção
Timely fluid administration is crucial to maintain tissue perfusion in septic shock patients. However, the question concerning which fluid should be used for septic shock resuscitation remains a matter of debate. A growing body of evidence suggests that the type, amount and timing of fluid administration during the course of sepsis may affect patient outcomes. Crystalloids have been recommended as the first-line fluids for septic shock resuscitation. Nevertheless, given the inconclusive nature of the available literature, no definitive recommendations about the most appropriate crystalloid solution can be made...
October 2016: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28099296/a-reexamination-of-the-accuracy-of-the-broselow-tape-as-an-instrument-for-weight-estimation
#4
Muhammad Waseem, Justin Chen, Mark Leber, Ashley E Giambrone, Linda M Gerber
BACKGROUND: Accurate weight estimation is important for calculating appropriate medication dosages, determining rates of fluid replacement, and selecting correct equipment sizes in critically ill children requiring resuscitation. The actual measurement of the weight of a critically ill or injured child is often not possible. The Broselow Pediatric Emergency Tape (BT) is an important tool for predicting a child's weight based on his/her height. Although BT has previously been validated, given the increasing prevalence of obesity in today's society, it behooves clinicians relying on this resuscitation aid to revisit the issue...
January 17, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28097104/massive-hemolysis-causing-renal-failure-in-acute-hepatitis-e-infection
#5
Pragya Karki, Sarthak Malik, Bipadabhanjan Mallick, Vishal Sharma, Surinder S Rana
Acute viral hepatitis is usually a self-limiting illness. However, it can lead to complications that can be life-threatening, such as acute liver failure. Glucose 6 phosphate dehydrogenase (G6PD) deficiency in the setting of acute viral hepatitis can lead to a massive hemolysis, manifesting as acute kidney injury and markedly raised bilirubin levels; although cases are rare. Here, we report such a case. The patient had a viral hepatitis E infection and presented with kidney injury requiring dialysis. Examination showed very high mixed hyperbilirubinemia due to massive intravascular hemolysis...
December 28, 2016: Journal of Clinical and Translational Hepatology
https://www.readbyqxmd.com/read/28094478/fluid-management-in-cardiac-surgery-patients-pitfalls-challenges-and-solutions
#6
Elena Bignami, Marcello Guarnieri, Marco Gemma
Fluid administration is a powerful tool for hemodynamic stabilization as it increases preload and improves cardiac function in fluid-responsive patients. However, there are various types of fluid to choose from. The use of colloids and crystalloids in non-cardiac Intensive Care Units (ICU) has been reported, showing controversial results. Many trials on sepsis in a non-cardiac ICU setting show that colloids, in particular hydroxyethyl starches and gelatins, might have a detrimental effect on kidney function, and on major outcomes such as mortality...
January 17, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28088774/association-between-e-alert-implementation-for-detection-of-acute-kidney-injury-and-outcomes-a-systematic-review
#7
Philippe Lachance, Pierre-Marc Villeneuve, Oleksa G Rewa, Francis P Wilson, Nicholas M Selby, Robin M Featherstone, Sean M Bagshaw
BACKGROUND: Electronic alerts (e-alerts) for acute kidney injury (AKI) in hospitalized patients are increasingly being implemented; however, their impact on outcomes remains uncertain. METHODS: We performed a systematic review. Electronic databases and grey literature were searched for original studies published between 1990 and 2016. Randomized, quasi-randomized, observational and before-and-after studies that included hospitalized patients, implemented e-alerts for AKI and described their impact on one of care processes, patient-centred outcomes or resource utilization measures were included...
January 14, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28078833/clinical-profile-and-outcome-of-patients-with-severe-sepsis-treated-in-an-intensive-care-unit-in-india
#8
T T Paary, M S Kalaiselvan, M K Renuka, A S Arunkumar
Introduction: Sepsis is the leading cause of intensive care unit (ICU) admissions and is associated with high mortality. Objectives: To identify the incidence, risk factors and outcome of patients with severe sepsis and septic shock. Methods: A prospective observational study was done in a multidisciplinary ICU over a period of 18 months. We included all adult patients admitted to ICU with features of severe sepsis and septic shock as per SCCM/ACCP guidelines...
30, 2016: Ceylon Medical Journal
https://www.readbyqxmd.com/read/28073139/-influence-of-comorbidities-on-revision-rate-within-the-first-year-after-primary-total-hip-arthroplasty
#9
Roman Nesslage, Kerstin Radtke, Lisa Hohloch, Thilo Flörkemeier, Henning Windhagen, Gabriela von Lewinski
: Background Total hip arthroplasty (THA) is very frequently performed. Despite low complication rates, revisions play an important clinical and economical role. The aim of this study was to identify comorbid diseases of patients undergoing primary THA and their potential influence on the survival of hip replacements. Patients/Material and Methods A total of 867 patients were included in this retrospective study. All revisions were reviewed that took place at our hospital within one year of primary implantation of THA...
January 10, 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/28070096/acute-kidney-injury-following-vomiting-and-diarrhea-after-endoscopy-in-a-duodenal-gastrinoma-patient
#10
Miyabi Miura, Kazuya Kitamura, Kuniaki Arai, Kazunori Kawaguchi, Taro Yamashita, Yoshio Sakai, Tatsuya Yamashita, Eishiro Mizukoshi, Masao Honda, Shuichi Kaneko
A 51-year-old woman complaining of weakness in the limbs was diagnosed as having a duodenal gastrinoma on performing a further evaluation. Surgical resection was performed with selective arterial calcium injection for localization. During preoperative hospitalization, she experienced recurrent severe vomiting and diarrhea after endoscopy, leading to acute kidney injury. To our knowledge, this is the first report of gastrinoma with post-endoscopy symptom exacerbation. Although the etiology is unknown, the findings in this case suggest that sufficient fluid replacement, sedation, and high-dose proton pump inhibitor administration should be taken into consideration when performing endoscopy in gastrinoma patients...
2017: Nihon Shokakibyo Gakkai Zasshi, the Japanese Journal of Gastro-enterology
https://www.readbyqxmd.com/read/28063042/murine-models-of-allergic-asthma
#11
Eline Haspeslagh, Nincy Debeuf, Hamida Hammad, Bart N Lambrecht
Allergic asthma is a heterogeneous inflammatory lung disease affecting millions of people worldwide and with a steadily increasing incidence. Mouse models have been of utmost importance in uncovering key inflammatory cell types, cytokines, and pathways in the development and maintenance of allergic asthma. Historically, the mainstay in experimental asthma research was sensitizing rodents to the model protein antigen ovalbumin (OVA) with the pro-Th2 adjuvant aluminum hydroxide, followed by repetitive OVA exposures to the airways to initiate a Th2-skewed adaptive immune response leading to eosinophilic airway inflammation and airway hyperreactivity (AHR)...
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/28055031/a-customized-mobile-application-in-colonoscopy-preparation-a-randomized-controlled-trial
#12
Ala I Sharara, Jean M Chalhoub, Maya Beydoun, Rani H Shayto, Hamed Chehab, Ali H Harb, Fadi H Mourad, Fayez S Sarkis
OBJECTIVES: Adherence with diet and prescribed purgative is essential for proper cleansing with low-volume bowel preparations. The aim of this work was to assess the effect of a customized mobile application (App) on adherence and quality of bowel preparation. METHODS: One hundred and sixty (160) eligible patients scheduled for elective colonoscopy were randomly assigned to paper (control) or App-based instructions. The preparation consisted of low-fiber diet for 2 days, clear fluids for one day and split-dose sodium picosulfate/magnesium citrate (SPS)...
January 5, 2017: Clinical and Translational Gastroenterology
https://www.readbyqxmd.com/read/28049033/cryptococcal-infection-of-the-ventriculoperitoneal-shunt-in-an-hiv-infected-patient-with-an-excellent-immunovirological-status
#13
Miguel Genebat, María J Mayorga-Buiza, Esperanza Castillo-Ojeda, Mónica Rivero-Garvía, Francisco J Márquez-Rivas, Manuel E Jiménez-Mejías
BACKGROUND: Cryptococcus is a rare cause of ventriculoperitoneal shunt infection, with a variable clinical presentation. Hence, diagnosis and therapeutic management of this entity is challenging. CASE DESCRIPTION: we herein describe the first reported case of cryptococcal ventriculoperitoneal shunt (VPS) infection in an HIV-infected subject with an excellent immunovirological status, with an abdominal mass as the only clinical sign at presentation. Microbiological diagnosis was confirmed when Cryptococcus neoformans was isolated in 4 cerebrospinal fluid samples on different days...
December 31, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/28048805/su-f-r-42-association-of-radiomic-and-metabolic-tumor-volumes-in-radiation-treatment-of-glioblastoma-multiforme
#14
C Lopez, N Nagornaya, N Parra, D Kwon, F Ishkanian, A Markoe, A Maudsley, R Stoyanova
PURPOSE: High-throughput extraction of imaging and metabolomic quantitative features from MRI and MR Spectroscopy Imaging (MRSI) of Glioblastoma Multiforme (GBM) results in tens of variables per patient. In radiotherapy (RT) of GBM, the relevant metabolic tumor volumes (MTVs) are related to aberrant levels of N-acetyl Aspartate (NAA) and Choline (Cho). Corresponding Clinical Target Volumes (CTVs) for RT planning are based on Contrast Enhancing T1-weighted MRI (CE-T1w) and T2-weighted/Fluid Attenuated Inversion Recovery (FLAIR) MRI...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28043422/extent-ii-thoracoabdominal-aortic-aneurysm-repair-how-i-do-it
#15
Joseph S Coselli, Kim I de la Cruz, Ourania Preventza, Scott A LeMaire, Scott A Weldon
The primary risks associated with thoracoabdominal aortic aneurysm (TAAA) repair-namely operative death, paraplegia, and renal failure necessitating dialysis-are commonly related to the distal ischemia that occurs during aortic clamping and the disruption of vital branching arteries. Our technique for open TAAA repair has evolved over the course of 3 decades, from the unheparinized, simple "clamp-and-sew" approach learned directly from E. Stanley Crawford himself to a contemporary, multimodal strategy that uses an array of surgical adjuncts...
July 2016: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28041954/lung-lavage-and-surfactant-replacement-during-ex-vivo-lung-perfusion-for-treatment-of-gastric-acid-aspiration-induced-donor-lung-injury
#16
Daisuke Nakajima, Mingyao Liu, Akihiro Ohsumi, Ricardo Kalaf, Ilker Iskender, Michael Hsin, Takashi Kanou, Manyin Chen, Brandon Baer, Rafael Coutinho, Lucas Maahs, Paula Behrens, Sassan Azad, Tereza Martinu, Thomas K Waddell, James F Lewis, Martin Post, Ruud A W Veldhuizen, Marcelo Cypel, Shaf Keshavjee
BACKGROUND: Ex vivo lung perfusion (EVLP) provides opportunities to treat injured donor lungs before transplantation. We investigated whether lung lavage, to eliminate inflammatory inhibitory components, followed by exogenous surfactant replacement, could aid lung recovery and improve post-transplant lung function after gastric aspiration injury. METHODS: Gastric acid aspiration was induced in donor pigs, which were ventilated for 6 hours to develop lung injury...
December 1, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28031654/aortic-root-rupture-during-transcatheter-aortic-valve-implantation-in-a-patient-with-idiopathic-thrombocytopenic-purpura-utility-of-transesophageal-echocardiography-in-early-detection-and-description-of-a-semiconservative-surgical-management-approach
#17
Jaya Chandrasekhar, Marc Ruel, Donna Nicholson, Marino Labinaz
An 87-year-old man with idiopathic thrombocytopenic purpura and platelet count of 56 × 10(9)/L underwent transesophageal echocardiography (TEE)-guided transcatheter aortic valve implantation using a femoral approach. Post valve deployment, a new pericardial effusion was noted which was successfully drained. Despite this, the patient became hypotensive needing vasopressor support with reaccumulation of pericardial fluid. Emergent sternotomy was performed and a perforation of the right ventricular apex was noted which was sealed with a pledgeted suture...
December 2016: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/28029208/pulmonary-and-tricuspid-valvuloplasty-in-carcinoid-heart-disease
#18
Ashkan Karimi, Negiin Pourafshar, James C Fudge
A 26-year-old female with carcinoid heart disease consisting of severe pulmonary and tricuspid valve stenosis was admitted with line associated sepsis. She recovered from sepsis with antibiotics and aggressive fluid resuscitation but became grossly volume overloaded with evidence of tense ascites and lower extremity edema. She developed worsening renal and hepatic function due to congestive nephropathy and hepatopathy, which did not respond to intravenous diuretics, and she was deemed too sick for surgical pulmonary and tricuspid valve replacement...
December 28, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28029154/changes-in-the-worldwide-epidemiology-of-peritoneal-dialysis
#19
REVIEW
Philip Kam-Tao Li, Kai Ming Chow, Moniek W M Van de Luijtgaarden, David W Johnson, Kitty J Jager, Rajnish Mehrotra, Sarala Naicker, Roberto Pecoits-Filho, Xue Qing Yu, Norbert Lameire
As the global burden of chronic kidney disease continues to increase, so does the need for a cost-effective renal replacement therapy. In many countries, patient outcomes with peritoneal dialysis are comparable to or better than those with haemodialysis, and peritoneal dialysis is also more cost-effective. These benefits have not, however, always led to increased utilization of peritoneal dialysis. Use of this therapy is increasing in some countries, including China, the USA and Thailand, but has proportionally decreased in parts of Europe and in Japan...
February 2017: Nature Reviews. Nephrology
https://www.readbyqxmd.com/read/28026109/soft-elastomers-with-ionic-liquid-filled-cavities-as-strain-isolating-substrates-for-wearable-electronics
#20
Yinji Ma, Matt Pharr, Liang Wang, Jeonghyun Kim, Yuhao Liu, Yeguang Xue, Rui Ning, Xiufeng Wang, Ha Uk Chung, Xue Feng, John A Rogers, Yonggang Huang
Managing the mechanical mismatch between hard semiconductor components and soft biological tissues represents a key challenge in the development of advanced forms of wearable electronic devices. An ultralow modulus material or a liquid that surrounds the electronics and resides in a thin elastomeric shell provides a strain-isolation effect that enhances not only the wearability but also the range of stretchability in suitably designed devices. The results presented here build on these concepts by (1) replacing traditional liquids explored in the past, which have some nonnegligible vapor pressure and finite permeability through the encapsulating elastomers, with ionic liquids to eliminate any possibility for leakage or evaporation, and (2) positioning the liquid between the electronics and the skin, within an enclosed, elastomeric microfluidic space, but not in direct contact with the active elements of the system, to avoid any negative consequences on electronic performance...
December 27, 2016: Small
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