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S L Cohen, S Senapati, A R Gargiulo, S S Srouji, F Tu, J Solnik, H-C Hur, A Vitonis, G M Jonsdottir, K C Wang, J I Einarsson
OBJECTIVE: To determine if higher-volume, fixed-dose administration of vasopressin further reduces blood loss at the time of minimally invasive myomectomy. DESIGN: Randomised multicentre clinical trial. SETTING: Tertiary-care academic centres in the USA. POPULATION: Women undergoing conventional laparoscopic or robot-assisted laparoscopic myomectomy. METHODS: All participants received the same 10-unit (U) dose of vasopressin, but were randomly assigned to one of two groups: (i) received 200 ml of diluted vasopressin solution (20 U in 400 ml normal saline), and (ii) received 30 ml of concentrated vasopressin solution (20 U in 60 ml normal saline)...
June 30, 2016: BJOG: An International Journal of Obstetrics and Gynaecology
Patrick M Honore, Rita Jacobs, Elisabeth De Waele, Marc Diltoer, Herbert D Spapen
Sepsis-induced acute kidney injury (SAKI) is traditionally viewed as a process driven by a reduced blood flow and prone to benefit from vasopressive support. In ovine hyperdynamic septic shock, Lankadeva et al. report a significant and flow-independent intrarenal perfusion and oxygenation "mismatch" jeopardizing the renal medulla that was aggravated by norepinephrine. Medullary and urinary oxygenation changed in parallel, suggesting that urinary oxygenation may act as a biomarker to predict SAKI.
July 2016: Kidney International
Solafah Abdalla, Antoine Brouquet, Thierry Lazure, Bruno Costaglioli, Christophe Penna, Stéphane Benoist
AIM: The study evaluated the outcome of severe acute antipsychotic (neuroleptic) drug-related colitis requiring emergency surgery. METHOD: From 2009 to 2014, 20 patients underwent emergency surgery for acute and severe neuroleptic-related ischaemic colitis. Neuroleptic-induced colitis was defined as another cause besides inflammatory, infectious or ischaemic colitis with a relationship to treatment by antipsychotic drug. RESULTS: The main drugs involved were Cyamemazine (n=9, 45%), Loxapine (n=5, 25%), Haloperidol (n=4, 20%) and Alimemazine (n=4, 20%)...
May 11, 2016: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Uberto Fumagalli, Alessandra Melis, Jana Balazova, Valeria Lascari, Emanuela Morenghi, Riccardo Rosati
This study aims to report the hypotensive episodes (HEs) during esophagectomy and their influence on the occurrence of anastomotic leak. Eighty-four patients underwent esophagectomy with gastric pull-up. Pre-, intra-, and post-operative data were prospectively collected. HEs were defined by systolic pressure decreasing more than 30 % of the basal value for more than 5 min. Nineteen patients had intra-operative HEs (22.6 %). HEs were significantly more frequent in patients undergoing prone esophagectomy (P = 0...
June 2016: Updates in Surgery
Satoshi Kawatsu, Shingo Takahara, Kou Sakatsume, Keisuke Kanda, Tomoyuki Suzuki, Shintaro Katahira, Hidenori Fujiwara, Osamu Adachi, Masatoshi Akiyama, Kiichiro Kumagai, Shunsuke Kawamoto, Yoshikatsu Saiki
Tolvaptan is a new selective vasopression V2-receptor antagonist. We report our experience with a use of tolvaptan for preoperative fluid management in a patient with severe constrictive pericarditis. A 66-year-old man presented with heart failure symptoms derived from constrictive pericarditis. Chest X-ray showed right pleural effusion and chest computed tomography demonstrated severe pericardial calcification. Despite that he received optimal conventional medical treatments, his hemodynamic condition further exacerbated during hospitalization...
February 2016: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Patricia Wiesen, Paul B Massion, Jean Joris, Olivier Detry, Pierre Damas
AIM: To determine renal dysfunction post liver transplantation, its incidence and risk factors in patients from a Belgian University Hospital. METHODS: Orthotopic liver transplantations performed from January 2006 until September 2012 were retrospectively reviewed (n = 187). Patients with no renal replacement therapy (RRT) before transplantation were classified into four groups according to their highest creatinine plasma level during the first postoperative week...
March 24, 2016: World Journal of Transplantation
Sylvain Malfroy, Florent Wallet, Delphine Maucort-Boulch, Laurent Chardonnal, Nicolas Sens, Arnaud Friggeri, Guillaume Passot, Olivier Glehen, Vincent Piriou
BACKGROUND AND OBJECTIVES: For patients suffering from peritoneal carcinomatosis, cytoreductive surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) is the only curative option. We focused on severe complications in the postoperative course of HIPEC. METHODS: We studied perioperative data from patients who underwent HIPEC between January 2010 and August 2011. Our primary objective was to identify perioperative risk factors for ICU admission. Our secondary objective was to identify patient that may be re-admitted to the ICU thanks to a prognostic score...
March 2016: Surgical Oncology
D Batouche, K Elhalimi, N Chaib, K Gaid, M A Negadi, Z Mentouri
OBJECTIFS: Le maintien d'une pression de perfusion cérébrale (PPC) entre 65-70mmHg chez l'enfant traumatisé crânien est un de nos objectifs de surveillance par le doppler transcrânien (DTC), mais peut céder la place à une personnalisation des objectifs hémodynamiques, cérébraux reposant sur un faisceau des paramètres qui sont « dépendants de chaque opérateur de garde ». À travers une observation nous allons pointer sur un effet iatrogène ayant conduit à un syndrome d'encéphalopathie postérieure réversible (SEPR)...
December 2015: Annales de Cardiologie et D'angéiologie
Tran Doan Ngoc Tran, Jeffrey M Gimble, Henrique Cheng
Intracellular Ca(2+) signals are essential for stem cell differentiation due to their ability to control signaling pathways involved in this process. Arginine vasopression (AVP) is a neurohypophyseal hormone that increases intracellular Ca(2+) concentration during adipogenesis via V1a receptors, Gq-proteins and the PLC-IP3 pathway in human adipose-derived stromal/stem cells (hASCs). These Ca(2+) signals originate through calcium release from pools within the endoplasmic reticulum and the extracellular space...
March 2016: Cell Calcium
Axel Andres, Tatsuya Kin, Doug O'Gorman, Scott Livingstone, David Bigam, Norman Kneteman, Peter Senior, A M James Shapiro
In islet transplantation, deceased cardiac death (DCD) donation has been identified as a potential extended source. There are currently no studies comparing outcomes between these categories, and our goal was to compare islet isolation success rates and transplantation outcomes between DCD and neurological determination of death (NDD) donors. Islet isolations from 15 DCD and 418 NDD were performed in our centre between September 2008 and September 2014. Donor variables, islet yields, metabolic function of isolated isled and insulin requirements at 1-month post-transplant were compared...
January 2016: Transplant International: Official Journal of the European Society for Organ Transplantation
Frederic Vanden Eynden, Gilles Mets, Filip De Somer, Stefaan Bouchez, Thierry Bove
BACKGROUND: Most therapeutic strategies for acute right ventricular failure (RVF) by pressure-overload are directed to improve cardiac output and coronary perfusion pressure by vasopressive agents. The eventual role of intra-aortic balloon counterpulsation (IABP) support remains questionable. This study investigates the contribution of IABP for acute RVF by pressure-overload, in comparison with phenylephrine (PE) and norepinephrine (NOR). METHODS: Acute RVF is induced by fixed pulmonary artery constriction in 6 pigs, pursuing a 50% reduction of cardiac output...
October 15, 2015: International Journal of Cardiology
Maria Vittoria Modica, Fabrizio Lombardo, Paolo Franchini, Marco Oliverio
BACKGROUND: Hematophagy arose independently multiple times during metazoan evolution, with several lineages of vampire animals particularly diversified in invertebrates. However, the biochemistry of hematophagy has been studied in a few species of direct medical interest and is still underdeveloped in most invertebrates, as in general is the study of venom toxins. In cone snails, leeches, arthropods and snakes, the strong target specificity of venom toxins uniquely aligns them to industrial and academic pursuits (pharmacological applications, pest control etc...
2015: BMC Genomics
Manassawee Korwutthikulrangsri, Pat Mahachoklertwattana, Rojjanee Lertbunrian, La-Or Chailurkit, Preamrudee Poomthavorn
BACKGROUND: Data on interrelationship between vitamin D deficiency (VDD) and adrenal insufficiency in critically ill children are limited. OBJECTIVE: To determine vitamin D status in critically ill children and its relationship with adrenal function. MATERIAL AND METHOD: Thirty-two patients and 36 controls were included. Serum 25-hydroxyvitamin D (25-OHD) levels were measured. Pediatric Risk of Mortality (PRISM) III score, outcome and adrenal function assessed by 1-microgram adrenocorticotropic hormone test were collected...
April 2015: Journal of the Medical Association of Thailand, Chotmaihet Thangphaet
A Lemaignen, G Birgand, W Ghodhbane, S Alkhoder, I Lolom, S Belorgey, F-X Lescure, L Armand-Lefevre, R Raffoul, M-P Dilly, P Nataf, J C Lucet
The incidence of surgical site infection (SSI) after cardiac surgery depends on the definition used. A distinction is generally made between mediastinitis, as defined by the US Centers for Disease Control and Prevention (CDC), and superficial SSI. Our objective was to decipher these entities in terms of presentation and risk factors. We performed a 7-year single centre analysis of prospective surveillance of patients with cardiac surgery via median sternotomy. SSI was defined as the need for reoperation due to infection...
July 2015: Clinical Microbiology and Infection
Anne Mossdorf, Florian Ulmer, Karsten Junge, Christoph Heidenhain, Marc Hein, Ilknur Temizel, Ulf Peter Neumann, Wenzel Schöning, Maximilian Schmeding
Introduction. The venovenous/portal venous (VVP) bypass technique has generally become obsolete in liver transplantation (LT) today. We evaluated our experience with 163 consecutive LTs that used a VVP bypass. Patients and Methods. The liver transplant program was started in our center in 2010. LTs were performed using an extracorporal bypass device. Results. Mean operative time was 269 minutes and warm ischemic time 43 minutes. The median number of transfusion of packed cells and plasma was 7 and 14. There was no intraoperative death, and the 30-day mortality was 3%...
2015: Gastroenterology Research and Practice
M V Filimonova, L I Shevchenko, T P Trofimova, V M Makarchuk, A S Shevchuk, G A Lushnikova
We studied the influence on hemodynamics and radioprotective activity of two inhibitors of NO-synthase (NOS)--isothiourea derivatives with different NOS isoform selectivity: T1023--a selective inhibitor of endothelial and inducible NOS; and NTT2--a highly selective inhibitor of neuronal NOS. Both compounds at a dose of 1/7 LD50/15 caused a vasopressive effect and baroreflex response in normal Wistar rats. However, the nature of hemodynamic changes was qualitatively different. T1023 caused a prolonged elevation of vascular tone and reflex shift resulted in a significant and lasting reduction in the systemic blood flow (35-45%), which created conditions for the development of circulatory hypoxia...
September 2014: Radiatsionnaia Biologiia, Radioecologiia
Daniel Clayton, Iresha Hanchapola, Walter G Thomas, Robert E Widdop, Alexander I Smith, Patrick Perlmutter, Marie-Isabel Aguilar
Angiotensin converting enzyme 2 (ACE2) is a zinc carboxypeptidase involved in the renin-angiotensin system (RAS) and inactivates the potent vasopressive peptide angiotensin II (Ang II) by removing the C-terminal phenylalanine residue to yield Ang1-7. This conversion inactivates the vasoconstrictive action of Ang II and yields a peptide that acts as a vasodilatory molecule at the Mas receptor and potentially other receptors. Given the growing complexity of RAS and level of cross-talk between ligands and their corresponding enzymes and receptors, the design of molecules with selectivity for the major RAS binding partners to control cardiovascular tone is an on-going challenge...
2015: Frontiers in Pharmacology
Juan Jacobo Ayala-Gaytán, Ángel Martínez-Vela, Homero Náñez-Terreros, Claudia Elena Guajardo-Lara, Salvador Bruno Valdovinos-Chávez
BACKGROUND: Necrotizing fasciitis (NF), myositis, and streptococcal toxic shock syndrome (STSS) associated with group G ß-hemolytic streptococcus (GGS) occasionally coincide. CLINICAL CASE: We describe a case of GGS simultaneously occurring with NF, myositis, arthritis, and STSS in an 83-year-old woman with sequelae of cerebrovascular disease, hospitalized after two days of fever and with a painful swollen left foot. She was hypotensive, her foot had purplish discoloration, which showed blisters spreading to the lower third of the leg, and no crepitus was present...
July 2014: Revista Médica del Instituto Mexicano del Seguro Social
Alana W Sullivan, Elsworth C Beach, Lucas A Stetzik, Amy Perry, Alyssa S D'Addezio, Bruce S Cushing, Heather B Patisaul
Impacts on brain and behavior have been reported in laboratory rodents after developmental exposure to bisphenol A (BPA), raising concerns about possible human effects. Epidemiological data suggest links between prenatal BPA exposure and altered affective behaviors in children, but potential mechanisms are unclear. Disruption of mesolimbic oxytocin (OT)/vasopressin (AVP) pathways have been proposed, but supporting evidence is minimal. To address these data gaps, we employed a novel animal model for neuroendocrine toxicology: the prairie vole (Microtus ochrogaster), which are more prosocial than lab rats or mice...
October 2014: Endocrinology
K Ameloot, K Van De Vijver, N Van Regenmortel, I De Laet, K Schoonheydt, H Dits, O Broch, B Bein, M L Malbrain
BACKGROUND: Nexfin® (BMEYE, Amsterdam, The Netherlands) is a totally non-invasive blood pressure and cardiac output (CO) monitor based on finger arterial pulse contour analysis. METHODS: We performed an open observational study in a mix of medical-surgical-burns critically ill patients (N.=45) to validate Nexfin obtained blood pressures (MAPnex) against PiCCO (MAPfem) derived blood pressure measurements. MAPnex, MAPfem and corresponding systolic (SBP) and diastolic (DBP) blood pressures were measured continuously and registered with a 2 hour interval during the 8-hour study period...
December 2014: Minerva Anestesiologica
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