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https://www.readbyqxmd.com/read/29157518/mechanical-circulatory-support-for-high-risk-pulmonary-embolism
#1
REVIEW
Mahir Elder, Nimrod Blank, Adi Shemesh, Mohit Pahuja, Amir Kaki, Tamam Mohamad, Theodore Schreiber, Jay Giri
Temporary mechanical circulatory support (MCS) devices have a role in treating high-risk patients with pulmonary embolism with cardiogenic shock. Mechanical circulatory device selection should be made based on center experience and device-specific features. All current devices are effective in decreasing right arterial pressure and providing circulatory support of 4 to 5 L/min. The pulmonary artery pulsatility index may prove to be an unreliable method to assess right ventricular function. Careful clinical evaluation on an individual patient basis should determine the need for MCS...
January 2018: Interventional cardiology clinics
https://www.readbyqxmd.com/read/29153594/the-effectiveness-of-extracorporeal-shockwave-treatment-in-subacromial-impingement-syndrome-and-its-relation-with-acromion-morphology
#2
Esra Circi, Sibel Caglar Okur, Ozge Aksu, Erhan Mumcuoglu, Tolga Tuzuner, Nil Caglar
OBJECTIVE: The aim of this study was to evaluate the effectiveness of the extracorporeal shock wave therapy in the subacromial impingement syndrome and its relationship with the acromion morphology. METHODS: Thirty patients (24 women, 6 men) with subacromial impingement were evaluated. The average age of patients was 53.6 ± 9.8 years (range 39-80). Patients were divided into 3 groups according to the acromion morphology. ESWT 1500 at 0.12 am mL/mm(2) violence was applied once a week for 3 weeks...
November 16, 2017: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/29151416/-short-term-deep-sedation-strategy-in-patients-with-spontaneous-intracerebral-hemorrhage-a-randomized-controlled-trial
#3
Zhuheng Wang, Chunzhi Shi, Liping Sun, Qinghua Guo, Wei Qiao, Guanhua Zhou
OBJECTIVE: To evaluate the efficacy and safety of short-term deep sedation strategy in patients with spontaneous intracerebral hemorrhage (ICH) after surgery. METHODS: A perspective, randomized, parallel-group study was conducted. Adult patients with spontaneous ICH and undergoing craniotomy admitted to Daxing Teaching Hospital of Capital Medical University from December 2015 to November 2016 were enrolled. The patients who received surgery were randomly divided into a short-term deep sedation and a slight and middle sedation group...
November 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29151364/a-clinical-prediction-model-to-identify-patients-at-high-risk-of-hemodynamic-instability-in-the-pediatric-intensive-care-unit
#4
Cristhian Potes, Bryan Conroy, Minnan Xu-Wilson, Christopher Newth, David Inwald, Joseph Frassica
BACKGROUND: Early recognition and timely intervention are critical steps for the successful management of shock. The objective of this study was to develop a model to predict requirement for hemodynamic intervention in the pediatric intensive care unit (PICU); thus, clinicians can direct their care to patients likely to benefit from interventions to prevent further deterioration. METHODS: The model proposed in this study was trained on a retrospective cohort of all patients admitted to a tertiary PICU at a single center in the United States, and validated on another retrospective cohort of all patients admitted to the PICU at a single center in the United Kingdom...
November 20, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29150999/focus-on-focus-lack-of-coherence-between-systemic-and-microvascular-indices-of-edema-formation
#5
Birkitt Ten Tusscher, Corien Gudden, Suus van Vliet, Bob Smit, Can Ince, E Christiaan Boerma, Harm-Jan S de Grooth, Paul W G Elbers
BACKGROUND: Fluid therapy remains a cornerstone of therapy in shock states. However, fluid overloading ultimately results in edema formation which is related to excess morbidity and mortality. Handheld microscopes are now frequently used to study the sublingual microcirculation. As a corollary, these devices measure focal distance, or surface to capillary distance. Physiologically, this could represent a microvascular index of edema formation and could have the potential to guide fluid therapy...
November 18, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29148174/prehospital-transfusion-of-red-cell-concentrates-in-a-paramedic-staffed-helicopter-emergency-medical-service
#6
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/29141400/antifungal-treatment-with-echinocandins-a-10-year-clinical-experience
#7
R Poves-Alvarez, B Cano-Hernández, S Balbás-Alvarez, P Román-García, M Heredia-Rodríguez, E Gómez-Sánchez, E Gómez-Pesquera, M Lorenzo-López, B Martínez-Rafael, M F Muñoz-Moreno, J M Eiros, E Tamayo
OBJECTIVE: The number of studies evaluating the use of echinocandins, whether or not its indication meets international guidelines, in clinical practice is limited. The objective of the present study was to determine the use of echinocandins in a tertiary Spanish hospital in 10 years of clinical practice, and to evaluate its impact on prognosis. METHODS: This retrospective study involved adult nonneutropenic ill patients with suspicion of fungal invasion who started treatment with echinocandins between 2006 and 2015...
November 10, 2017: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
https://www.readbyqxmd.com/read/29136126/risk-of-subsequent-sepsis-within-90-days-of-a-previous-hospital-stay-by-type-of-antibiotic-exposure
#8
James Baggs, Johm A Jernigan, Alison Laufer Halpin, Lauren H Epstein, Kelly M Hatfield, L Clifford McDonald
Background: We examined the risk of sepsis within 90 days after discharge from a previous hospital stay by type of antibiotic received during the previous stay. Methods: We retrospectively identified a cohort of hospitalized patients from the Truven Health MarketScan Hospital Drug Database. We examined the association between the use of certain antibiotics, determined a priori, during the initial hospital stay and risk of post-discharge sepsis controlling for potential confounding factors in a multivariable logistic regression model...
November 9, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29135807/effects-of-stressor-controllability-on-transcriptional-levels-of-c-fos-arc-and-brain-derived-neurotrophic-factor-in-mouse-amygdala-and-medial-prefrontal-cortex
#9
Mayumi Machida, György Lonart, Larry D Sanford
Controllability is an important factor in determining stress outcomes. Uncontrollable stress is associated with the development of psychopathology such as post-traumatic stress disorder, whereas controllable stress is associated with adaptive stress responses and positive outcomes. In this study, we investigated how controllability affects poststress neurobiology by assessing transcriptional levels of activity-dependent genes in medial prefrontal cortex (mPFC) and amygdala, regions important in mediating stress outcomes...
November 13, 2017: Neuroreport
https://www.readbyqxmd.com/read/29135535/blood-glucose-concentrations-in-prehospital-trauma-patients-with-traumatic-shock-a-retrospective-analysis
#10
Janett Kreutziger, Wolfgang Lederer, Stefan Schmid, Hanno Ulmer, Volker Wenzel, Maarten W Nijsten, Daniel Werner, Thomas Schlechtriemen
BACKGROUND: Deranged glucose metabolism after moderate to severe trauma with either high or low concentrations of blood glucose is associated with poorer outcome. Data on prehospital blood glucose concentrations and trauma are scarce. OBJECTIVES: The primary aim was to describe the relationship between traumatic shock and prehospital blood glucose concentrations. The secondary aim was to determine the additional predictive value of prehospital blood glucose concentration for traumatic shock when compared with vital parameters alone...
November 11, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29133561/outcomes-of-vancomycin-plus-a-%C3%AE-lactam-versus-vancomycin-only-for-the-treatment-of-methicillin-resistant-staphylococcus-aureus-bacteremia
#11
James Truong, John J Veillette, Steve C Forland
The objective of this retrospective study was to compare the rates of treatment failure, which was a composite of clinical and microbiologic failure, of patients receiving vancomycin and a β-lactam to those receiving vancomycin only for MRSA bacteremia. Patients 16 to 89 years of age with MRSA bacteremia admitted to a university-affiliated hospital from January 1(st), 2014 to December 31(st), 2016 were screened for study inclusion. Patients were eligible if they received >48 hours of vancomycin and a β-lactam (combination group) or vancomycin only (standard group) within 48 hours following bacteremia onset...
November 13, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/29132057/predictors-of-hemodynamic-derangement-during-intubation-in-the-critically-ill-a-nested-case-control-study-of-hemodynamic-management-part-ii
#12
Nathan J Smischney, Mohamed O Seisa, Katherine J Heise, Robert A Wiegand, Kyle D Busack, Jillian L Deangelis, Theodore O Loftsgard, Darrell R Schroeder, Daniel A Diedrich
PURPOSE: Our primary aim was to identify predictors of immediate hemodynamic decompensation during the peri-intubation period. METHODS: We conducted a nested case-control study of a previously identified cohort of adult patients needing intubation admitted to a medical-surgical ICU during 2013-2014. Hemodynamic derangement was defined as cardiac arrest and/or the development of systolic blood pressure <90mmHg and/or mean arterial pressure <65mmHg 30min following intubation...
October 16, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29129185/combined-use-of-high-doses-of-vasopressin-and-corticosteroids-in-a-patient-with-crohn-s-disease-with-refractory-septic-shock-after-intestinal-perforation-a-case-report
#13
Salvatore Notaro, Marcello Sorrentino, Aniello Ruocco, Annalisa Notaro, Antonio Corcione, Patrizia Murino, Eugenio Piscitelli, Marianna Tamborino
BACKGROUND: In this article, we present a clinical case of refractory septic shock resulting from intestinal perforation treated with high doses of vasopressin and hydrocortisone during emergency surgery. The use of such high doses of vasopressin for this type of shock is not described in the literature. CASE PRESENTATION: A 49-year-old white woman with grade III obesity, Crohn's disease, and an intestinal perforation presented with refractory septic shock. Initially, a low dose of vasopressin was used...
November 13, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29127030/hybridization-improved-bacteria-resistance-in-abalone-evidence-from-physiological-and-molecular-responses
#14
Shuang Liang, Xuan Luo, Weiwei You, Caihuan Ke
Hybridization is an effective way of improving germplasm in abalone, as it often generates benign traits in the hybrids. The hybrids of Haliotis discus hannai and H. gigantea have shown heterosis in terms of disease resistance than one or both parental species. In the present study, to elucidate the physiological and molecular mechanism of this heterosis, we analyzed the dynamic changes of several immune indexes including survival rate, total circulating haemocyte count (THC), phagocytic activity, reactive oxygen species level (ROS) and phenoloxidase activity (PO) in two parental species, H...
November 7, 2017: Fish & Shellfish Immunology
https://www.readbyqxmd.com/read/29126885/medial-frontal-cortex-response-to-unexpected-motivationally-salient-outcomes
#15
Heather E Soder, Geoffrey F Potts
The medial frontal cortex (MFC) plays a central role allocating resources to process salient information, in part by responding to prediction errors. While there is some recent debate, the feedback-related negativity (FRN) is thought to index a reward prediction error by signaling outcomes that are worse than expected. A recent study utilizing electric shock provided data inconsistent with these accounts and reported that the omission of both appetitive (money) and aversive outcomes (electric shocks) elicited a medial frontal negativity...
November 7, 2017: International Journal of Psychophysiology
https://www.readbyqxmd.com/read/29126662/levosimendan-in-patients-with-cardiogenic-shock-complicating-myocardial-infarction-a-meta-analysis
#16
M Fang, H Cao, Z Wang
PURPOSE: Cardiac shock is the leading cause of death in patients with acute myocardial infarction. The objective of this systematic review and meta-analysis was to evaluate whether levosimendan, compared to any type of control, is associated with improved clinical outcomes in patients with cardiogenic shock complicating myocardial infarction. MATERIALS AND METHODS: The PubMed, EMBASE, Cochrane Central Register, and China National Knowledge Information databases were searched for pertinent studies published up until 1 May 2016...
November 7, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/29126550/trends-in-pediatric-adjusted-shock-index-predict-morbidity-and-mortality-in-children-with-severe-blunt-injuries
#17
Robert J Vandewalle, Julia K Peceny, Scott C Dolejs, Jodi L Raymond, Thomas M Rouse
PURPOSE: The utility of measuring the pediatric adjusted shock index (SIPA) at admission for predicting severity of blunt injury in pediatric patients has been previously reported. However, the utility of following SIPA after admission is not well described. METHODS: The trauma registry from a level-one pediatric trauma center was queried from January 1, 2010 to December 31, 2015. Patients were included if they were between 4 and 16years old at the time of admission, sustained a blunt injury with an Injury Severity Score≥15, and were admitted less than 12h after their injury (n=286)...
October 14, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29119963/-what-physiotherapeutic-method-for-the-treatment-of-post-mastectomy-lymphedema-is-the-most-effective
#18
T I Grushina
We have undertaken the search for the publications of interest in the following databases: Scopus, Web of Science, MedLine, The Cochrane Library, CyberLeninka, and Russian science citation index. In addition, we evaluated the effectiveness of the physical agents and procedures having different mechanisms of action of the known factors responsible for the development of post-mastectomy lymphedema. Such agents and procedures include self-massage, manual lymphatic drainage, therapeutic physical exercises, compression bandaging, wearing elastic compression garments, Kinesio Tex taping, pneumatic compression, ultrasonic, electrostatic, extracorporeal shock wave therapy, electrical muscle stimulation, microcurrent and low-intensity laser therapy...
2017: Voprosy Kurortologii, Fizioterapii, i Lechebnoĭ Fizicheskoĭ Kultury
https://www.readbyqxmd.com/read/29119223/-acute-myocardial-infarction-in-patients-with-st-segment-elevation-myocardial-infarction-esc-guidelines-2017
#19
REVIEW
H Thiele, S Desch, S de Waha
This article gives an update on the management of acute ST-segment elevation myocardial infarction (STEMI) according to the recently released European Society of Cardiology guidelines 2017 and the modifications are compared to the previous STEMI guidelines from 2012. Primary percutaneous coronary intervention (PCI) remains the preferred reperfusion strategy. New guideline recommendations relate to the access site with a clear preference for the radial artery, use of drug-eluting stents over bare metal stents, complete revascularization during the index hospitalization, and avoidance of routine thrombus aspiration...
November 8, 2017: Herz
https://www.readbyqxmd.com/read/29113999/index-of-microcirculatory-resistance-at-the-time-of-primary-percutaneous-coronary-intervention-predicts-early-cardiac-complications-insights-from-the-oxami-oxford-study-in-acute-myocardial-infarction-cohort
#20
Gregor Fahrni, Mathias Wolfrum, Giovanni Luigi De Maria, Florim Cuculi, Sam Dawkins, Mohammad Alkhalil, Niket Patel, John C Forfar, Bernard D Prendergast, Robin P Choudhury, Keith M Channon, Adrian P Banning, Rajesh K Kharbanda
BACKGROUND: Early risk stratification after primary percutaneous coronary intervention (PPCI) for ST-segment-elevation myocardial infarction is currently challenging. Identification of a low-risk group may improve triage of patients to alternative clinical pathways and support early hospital discharge. Our aim was to assess whether the index of microcirculatory resistance (IMR) at the time of PPCI can identify patients at low risk of early major cardiac complications and to compare its performance against guideline-recommended risk scores...
November 7, 2017: Journal of the American Heart Association
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