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https://www.readbyqxmd.com/read/29338968/an-alternative-tool-for-triaging-patients-with-possible-acute-coronary-symptoms-before-admission-to-a-chest-pain-unit
#1
Kuang-Chau Tsai, Ray F Lin, Chieh Lee, Ai-Hsien Li
OBJECTIVE: This study aimed to develop a triage tool to more effectively triage possible ACS patients presenting to the emergency department (ED) before admission to a protocol-driven chest pain unit (CPU). METHODS: Seven hundred ninety-three clinical cases, randomly selected from 7962 possible ACS cases, were used to develop and test an ACS triage model using cluster analysis and stepwise logistic regression. RESULTS: The ACS triage model, logit (suspected ACS patient)=-5...
December 13, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29333566/principles-of-management-of-central-nervous-system-infections
#2
REVIEW
Sunit Singhi, Suresh Kumar Angurana
CNS infections in children are medical emergency and are associated with high mortality and morbidity. For diagnosis, a high index of suspicion is required. Clinical assessment should be supplemented by laboratory investigations including CSF Gram stain and cultures, blood culture, PCR on CSF, serological tests, and imaging. Commonly associated life threatening complications include coma, seizure, raised intracranial pressure (ICP), focal deficits, shock, respiratory failure, and fluid and electrolyte abnormalities...
January 15, 2018: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/29333511/evaluating-the-importance-of-different-computed-tomography-scan-based-factors-in-predicting-the-outcome-of-extracorporeal-shock-wave-lithotripsy-for-renal-stones
#3
Muhammad Waqas, Imad-Ud-Din Saqib, Muhammad Imran Jamil, Mohammad Ayaz Khan, Saeed Akhter
Purpose: To evaluate the impact of various computed tomography scan-based parameters of renal stones on the outcome of extracorporeal shock wave lithotripsy (ESWL). Materials and Methods: We conducted a retrospective study of patients who underwent ESWL for renal stones (sized 5-20 mm) from January 2013 to December 2016. We evaluated body mass index, location of the stone, skin-to-stone distance (SSD), stone attenuation value (SAV), stone diameter, Hounsfield density, stone area, and stone volume...
January 2018: Investigative and Clinical Urology
https://www.readbyqxmd.com/read/29333461/extracorporeal-shock-wave-therapy-for-coronary-artery-disease-relationship-of-symptom-amelioration-and-ischemia-improvement
#4
Youko Takakuwa, Masayoshi Sarai, Hideki Kawai, Akira Yamada, Kenji Shiino, Kayoko Takada, Yasuomi Nagahara, Meiko Miyagi, Sadako Motoyama, Hiroshi Toyama, Yukio Ozaki
Objectives: The current management of coronary artery disease (CAD) relies on three major therapeutic options, namely medication, percutaneous coronary intervention (PCI), and coronary artery bypass grafting (CABG). However, severe CAD that is not indicated for PCI or CABG still bears a poor prognosis due to the lack of effective treatments. In 2006, extracorporeal cardiac shock wave (SW) therapy reported on human for the first time. This treatment resulted in better myocardial perfusion as evaluated by dipyridamole stress thallium scintigraphy, angina symptoms, and exercise tolerance...
2018: Asia Oceania Journal of Nuclear Medicine & Biology
https://www.readbyqxmd.com/read/29332774/an-analysis-of-intoxicated-patients-transported-by-a-doctor-helicopter
#5
Ikuto Takeuchi, Kazuhiko Omori, Hiroki Nagasawa, Kei Jitsuiki, Takashi Iso, Akihiko Kondo, Kouhei Ishikawa, Hiromichi Ohsaka, Youichi Yanagawa
OBJECTIVE: We retrospectively investigated all of the intoxicated patients who were transported by a doctor helicopter (DH) in eastern Shizuoka between April 2004 and December 2015 to determine when air medical transport was used in cases of toxic exposure. METHODS: Subjects were divided into 2 groups: an outpatient group of subjects who went home after receiving a medical evaluation and treatment and an admission group. RESULTS: The outpatient and admission groups included 17 and 31 subjects, respectively...
January 2018: Air Medical Journal
https://www.readbyqxmd.com/read/29328935/evaluation-of-robustness-of-activated-sludge-using-calcium-induced-enhancement-of-respiration
#6
Zhi-Hua Li, Yuan-Mo Zhu, Jing Zhang, Cheng-Jian Yang, Tian-Yu Zhang, Han-Qing Yu
Robustness of an activated sludge system, describing uncertainty and operational risk, was evaluated using the absence or presence of calcium-induced enhancement of respiration (CaER) effect. Generally, the fast-growing system was susceptible to external environmental variations, of which the sludge exhibited significant CaER effect under normal operational conditions, while the slow growing system showed less significant CaER effect. However, sludge in both systems exhibited CaER effect under stressed conditions of decreasing temperature or ammonia shocking...
January 4, 2018: Bioresource Technology
https://www.readbyqxmd.com/read/29327602/combination-therapy-versus-exercise-and-orthotic-support-in-the-management-of-pain-in-plantar-fasciitis-a-randomized-controlled-trial
#7
Eda Cinar, Shikha Saxena, Fatma Uygur
BACKGROUND: This study aimed at estimating the effectiveness of two commonly used modalities-extracorporeal shock wave therapy (ESWT) and low-level laser therapy (LLLT)-each combined with usual care (exercises and orthotic supports) in comparison to only usual care to relieve pain in patients with plantar fasciitis (PF). METHODS: Participants with PF were randomly allocated into 3 groups: ESWT (n = 25), LLLT (n = 24), and control (n = 17). All participants received a home exercise program with orthotic support...
January 1, 2018: Foot & Ankle International
https://www.readbyqxmd.com/read/29315095/observational-study-in-healthy-volunteers-to-define-interobserver-reliability-of-ultrasound-haemodynamic-monitoring-techniques-performed-by-trainee-doctors
#8
Benjamin M Bussmann, Shrey Sharma, David Mcgregor, William Hulme, Tim Harris
OBJECTIVES: Bedside ultrasound is increasingly being used to guide fluid management in shocked patients. Little data exist on the inter-rater reliability of techniques used, especially when performed by nonexpert trainee doctors. The primary aim of this study is to measure the inter-rater reliability of five ultrasound techniques commonly used to guide fluid management: inferior vena cava collapsibility index (IVCCI), transthoracic echocardiography (TTE)-derived stroke volumes, ultrasound cardiac output monitor (USCOM) derived stroke volume and carotid artery blood flow and corrected flow time measurements...
January 8, 2018: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/29308756/-establishment-of-multiple-organ-dysfunction-syndrome-early-warning-score-in-patients-with-severe-trauma-and-its-clinical-significance-a-multicenter-study
#9
Wenjuan Huang, Song Qin, Yu Sun, Shangqi Yin, Xia Fan, Qi Huang, Tao Chen, Huaping Liang
OBJECTIVE: To explore the risk factors of multiple organ dysfunction syndrome (MODS) in severe trauma patients, put forward a new warning scoring system of MODS, and to provide a more accurate scoring method for doctors to judge the clinical condition and prognosis of patients. METHODS: Clinical data of 342 patients with severe trauma admitted to intensive care unit (ICU) of the Affiliated Hospital of Zunyi Medical College and Daping Hospital of the Third Military Medical University from January 1st, 2015 to December 31st, 2016 were retrospectively analyzed...
January 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29303029/the-use-of-ecmo-for-the-treatment-of-refractory-cardiac-arrest-or-postarrest-cardiogenic-shock-following-in-hospital-cardiac-arrest-a-10-year-experience
#10
Meshe Chonde, Penny Sappington, Robert Kormos, Andrew Althouse, Arthur Boujoukos
OBJECTIVES: Extracorporeal membrane oxygenation (ECMO) has been increasingly used in the treatment of refractory cardiac arrest (extracorporeal cardiopulmonary resuscitation [ECPR]) and postarrest cardiogenic shock (PACS). Our primary objective was to determine the 1-year survival of patients who were treated with ECMO for PACS or in ECPR. METHODS: We conducted a retrospective analysis of hospitalized patients in a tertiary care facility who underwent treatment with ECMO for ECPR or PACS...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29287365/dephosphorylation-enhances-postmortem-degradation-of-myofibrillar-proteins
#11
Zheng Li, Meng Li, Manting Du, Qingwu W Shen, Dequan Zhang
Protein degradation is primarily responsible for postmortem meat tenderization, which might be affected by phosphorylation. The objective of this study was to investigate the effect of phosphorylation on myofibrillar proteins degradation in muscle during postmortem. Here we modulated the phosphorylation status of protein by protein kinase inhibitor and phosphatase inhibitor, and the effect of these inhibitors on myofibrillar protein degradation was evaluated. Generally, myofibril fragmentation index of samples with lower phosphorylation level was higher...
April 15, 2018: Food Chemistry
https://www.readbyqxmd.com/read/29287059/microfluidics-a-high-throughput-system-for-the-assessment-of-the-endotheliopathy-of-trauma-and-the-effect-of-timing-of-plasma-administration-on-ameliorating-shock-associated-endothelial-dysfunction
#12
Lawrence N Diebel, Jonathan V Martin, David M Liberati
BACKGROUND: Early resuscitation after trauma-hemorrhagic shock (HS) with plasma rather than crystalloid may ameliorate systemic endothelial cell (EC) injury and dysfunction (endotheliopathy of trauma [EOT]). We postulated that endothelial lined microfluidic networks would be a useful platform to study the endothelial cell activation/injury under flow conditions to mimic HS. We then used the microfluidic system to further characterize the protective effects and optimal timing of plasma infusion on the development of "EOT" in our model...
December 28, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29283920/does-lactate-affect-the-association-of-early-hyperglycemia-and-multiple-organ-failure-in-severely-injured-blunt-trauma-patients
#13
Justin E Richards, Thomas M Scalea, Michael A Mazzeffi, Peter Rock, Samuel M Galvagno
BACKGROUND: Early hyperglycemia is associated with multiple organ failure (MOF) after traumatic injury; however, few studies have considered the contribution of depth of clinical shock. We hypothesize that when considered simultaneously, glucose and lactate are associated with MOF in severely injured blunt trauma patients. METHODS: We performed a retrospective investigation at a single tertiary care trauma center. Inclusion criteria were patient age ≥18 years, injury severity score (ISS) >15, blunt mechanism of injury, and an intensive care unit length of stay >48 hours...
December 26, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29282161/generalisation-of-fear-in-ptsd-related-to-prolonged-childhood-maltreatment-an-experimental-study
#14
Janine Thome, Sophie Hauschild, Georgia Koppe, Lisa Liebke, Sophie Rausch, Julia I Herzog, Meike Müller-Engelmann, Regina Steil, Kathlen Priebe, Dirk Hermans, Christian Schmahl, Martin Bohus, Stefanie Lis
BACKGROUND: Fear responses are particularly intense and persistent in post-traumatic stress disorder (PTSD), and can be evoked by unspecific cues that resemble the original traumatic event. Overgeneralisation of fear might be one of the underlying mechanisms. We investigated the generalisation and discrimination of fear in individuals with and without PTSD related to prolonged childhood maltreatment. METHODS: Sixty trauma-exposed women with (N = 30) and without (N = 30) PTSD and 30 healthy control participants (HC) underwent a fear conditioning and generalisation paradigm...
December 28, 2017: Psychological Medicine
https://www.readbyqxmd.com/read/29251715/a-retrospective-analysis-of-the-respiratory-adjusted-shock-index-rasi-to-determine-the-presence-of-occult-shock-in-trauma-patients
#15
Nicholas Caputo, James Reilly, Marc Kanter, Jason West
BACKGROUND: The shock index (SI), calculated as HR/SBP, is a simple hemodynamic marker that may be used to assess for the presence of occult shock in trauma patients. The normal range for a healthy adult patient is 0.5 to 0.7. Recently, studies have demonstrated that tachypnea is the most important predictor of cardiac arrest in hospital wards and is an important indicator of derangements across multiple organ systems. As such, we have sought to determine whether the inclusion of the patient's respiratory rate to the already existing shock index (called the Respiratory Adjusted Shock Index- RASI), calculated as HR/SBP*(RR/10), will improve the overall diagnostic accuracy of detecting patients in early occult shock...
December 14, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29249595/is-emergency-transcatheter-hepatic-arterial-embolization-suitable-for-spontaneously-ruptured-hepatocellular-carcinoma-in-child-pugh-c-cirrhosis
#16
Wen-Zhe Fan, Ying-Qiang Zhang, Wang Yao, Yu Wang, Guo-Sheng Tan, Yong-Hui Huang, Jian-Yong Yang, Jia-Ping Li
PURPOSE: To evaluate the utility of emergent transcatheter arterial embolization for spontaneously ruptured hepatocellular carcinoma (HCC) in patients with Child-Pugh class C (CPC) liver cirrhosis presenting hemorrhagic shock. MATERIALS AND METHODS: A study of all 94 patients was retrospectively conducted from January 2006 to January 2016. Sixty patients underwent conservative treatment (control group) and 34 underwent embolization. RESULTS: Embolization provided better stabilization of hemodynamic status than conservative treatment (91...
December 14, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/29245998/effects-of-levosimendan-on-mortality-in-patients-with-septic-shock-systematic-review-with-meta-analysis-and-trial-sequential-analysis
#17
Benji Wang, Rujie Chen, Xianyang Guo, Wenwu Zhang, Jianjian Hu, Yuqiang Gong, Bihuan Cheng
Object: Several studies have investigated a survival benefit for levosimendan treatment in patients with septic shock. However, data are conflicting. We conducted a meta-analysis to evaluate the effect of levosimendan treatment on mortality in patients with septic shock. Materials and Methods: We searched PubMed, EMBASE and Cochrane Library Databases up to March 27, 2017, without language restrictions. We searched for terms related to septic shock, levosimendan, randomized clinical trial...
November 21, 2017: Oncotarget
https://www.readbyqxmd.com/read/29240642/body-mass-s-impact-on-response-to-fixed-dose-vasopressin-in-patients-with-septic-shock
#18
Heather Torbic, Gretchen L Sacha, Seth R Bauer, Simon W Lam
INTRODUCTION: The effect of patient weight and body mass index (BMI) on hemodynamic response to vasoactive medications is not fully understood. In titratable vasopressors, this effect is less likely a concern due to the ability to titrate dose to response, however, with the use of fixed-dose vasopressin, patient weight and BMI may impact response. METHODS: This was a single center, retrospective cohort of patients who received fixed-dose vasopressin for septic shock for ≥6 hours with concomitant catecholamines in the medical, surgical, or neurosciences intensive care unit (ICU) at a tertiary care center...
December 13, 2017: Shock
https://www.readbyqxmd.com/read/29239263/percutaneous-mechanical-thrombectomy-combined-with-catheter-directed-thrombolysis-in-the-treatment-of-acute-pulmonary-embolism-and-lower-extremity-deep-venous-thrombosis-a-novel-one-stop-endovascular-strategy
#19
Bing Liu, MingYuan Liu, LiHong Yan, JunWei Yan, Jiang Wu, XueFei Jiao, MingJin Guo
Objective This study was performed to evaluate the efficacy and feasibility of percutaneous mechanical thrombectomy (PMT) combined with catheter-directed thrombolysis (CDT) in patients with acute pulmonary embolism (APE) and lower extremity deep venous thrombosis (LEDVT). Methods In total, 20 consecutive patients with APE and LEDVT were prospectively selected for PMT combined with CDT. Mechanical thrombus fragmentation and aspiration using a pigtail rotation catheter followed by CDT was performed in each patient...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/29227368/septic-cardiomyopathy
#20
Sarah J Beesley, Gerhard Weber, Todd Sarge, Sara Nikravan, Colin K Grissom, Michael J Lanspa, Sajid Shahul, Samuel M Brown
OBJECTIVES: To describe, with an emphasis on clinical applications, what is known about the pathophysiology, management, and implications of septic cardiomyopathy in the adult ICU. DATA SOURCES AND STUDY SELECTION: A PubMed literature review was performed for relevant articles. Only articles in English that studied human adults with sepsis were included. DATA EXTRACTION AND DATA SYNTHESIS: Multiple competing definitions for septic cardiomyopathy hinder understanding of this entity...
December 8, 2017: Critical Care Medicine
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