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Hemorrhagic shock

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https://www.readbyqxmd.com/read/28214483/systemic-thrombolysis-increases-hemorrhagic-stroke-risk-without-survival-benefit-compared-with-catheter-directed-intervention-for-the-treatment-of-acute-pulmonary-embolism
#1
Nathan L Liang, Efthymios D Avgerinos, Michael J Singh, Michel S Makaroun, Rabih A Chaer
BACKGROUND: Systemic thrombolysis (ST) and catheter-directed intervention (CDI) are both used in the treatment of acute pulmonary embolism (PE), but the comparative outcomes of these two therapies remain unclear. The objective of this study was to compare short-term mortality and safety outcomes between the two treatments using a large national database. METHODS: Patients presenting with acute PE were identified in the National Inpatient Sample (NIS) from 2009 to 2012...
March 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28213377/interventional-treatment-of-pulmonary-embolism
#2
David M Dudzinski, Jay Giri, Kenneth Rosenfield
Pulmonary embolism (PE) is a serious and prevalent cause of vascular disease. Nevertheless, optimal treatment for many phenotypes of PE remains uncertain. Treating PE requires appropriate risk stratification as a first step. For the highest-risk PE, presenting as shock or arrest, emergent systemic thrombolysis or embolectomy is reasonable, while for low-risk PE, anticoagulation alone is often chosen. Normotensive patients with PE but with indicia of right heart dysfunction (by biomarkers or imaging) constitute an intermediate-risk group for whom there is controversy on therapeutic strategy...
February 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28212620/clinical-manifestations-of-severe-enterovirus-71-infection-and-early-assessment-in-a-southern-china-population
#3
Si-da Yang, Pei-Qing Li, Yi-Min Li, Wei Li, Wen-Ying Lai, Cui-Ping Zhu, Jian-Ping Tao, Li Deng, Hong-Sheng Liu, Wen-Cheng Ma, Jia-Ming Lu, Yan Hong, Yu-Ting Liang, Jun Shen, Dan-Dan Hu, Yuan-Yuan Gao, Yi Zhou, Min-Xiong Situ, Yan-Ling Chen
BACKGROUND: Enterovirus 71 (EV-A71) shows a potential of rapid death, but the natural history of the infection is poorly known. This study aimed to examine the natural history of EV-A71 infection. METHODS: This was a prospective longitudinal observational study performed between January 1(st) and October 31(st), 2012, at three hospitals in Guangdong, China. Subjects with positive EV-A71 RNA laboratory test results were included. Disease progression was documented with MRI, autopsies, and follow-up...
February 17, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28207628/earlier-endpoints-are-required-for-hemorrhagic-shock-trials-among-severely-injured-patients
#4
Erin E Fox, John B Holcomb, Charles E Wade, Eileen M Bulger, Barbara C Tilley
BACKGROUND: Choosing the appropriate endpoint for a trauma hemorrhage control trial can determine the likelihood of its success. Recent Phase 3 trials and observational studies have used 24-h and/or 30-day all-cause mortality as the primary endpoint and some have not used exception from informed consent (EFIC), resulting in multiple failed trials. Five recent high-quality prospective studies among 4,064 hemorrhaging trauma patients provide new evidence to support earlier primary endpoints...
February 15, 2017: Shock
https://www.readbyqxmd.com/read/28196269/shock-index-and-vital-sign-reference-ranges-during-the-immediate-postpartum-period
#5
Dyese Taylor, Adiel Fleischer, Natalie Meirowitz, Lisa Rosen
OBJECTIVE: To determine reference ranges for patient vital signs during the immediate postpartum period. METHODS: A retrospective chart review collected data on the variables of interest for all women with 0-24-hour postpartum data available at two hospitals in New York, NY, USA, between July 1, 2012, and January 31, 2015. Patients were excluded if they had received antihypertensives, uterotonics, or blood products. Regression lines, with 95% prediction intervals, were constructed for shock index, systolic blood pressure, heart rate, pulse pressure, and rate over pressure evaluation (ROPE) values...
February 14, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28191012/application-of-modified-small-bladder-patch-to-bladder-double-layer-sutures-to-improve-renal-transplantation-in-mice
#6
Chen Wenwei, Yang Yirong, Katarzyna M Stevens, Michal Heger, Xia Peng
BACKGROUND: This study aimed to introduce an improved surgical procedure to reduce the incidence of urinary tract complications after renal transplantation in mice using a modified bladder patch-to-bladder anastomosis technique. METHODS: Renal isotransplantation was performed in 28 male C57BL/6 mice. The urinary tract was reconstructed with a ureteral anastomosis between the donor's small bladder patch and the recipient's bladder. The bladder patch was secured through a cystotomy in the recipient's bladder mucosa and seromuscular layers, which were sutured in a double-layer manner...
2017: European Surgery: ACA: Acta Chirurgica Austriaca
https://www.readbyqxmd.com/read/28184956/-hemorrhagic-shock-general-principles
#7
T I Eiben, V Fuhrmann, B Saugel, S Kluge
Bleeding associated with hemorrhagic shock is often seen in emergency medical services or in the intensive care unit. Identifying the origin of the bleeding and additional disorders helps to determine the degree of the hemorrhagic shock. In order to be effective, the initial therapy until blood products are available needs to be differentiated to be effective in terms of hemodynamic stabilization and coagulation. Crystalloidal and colloidal solutions should be used carefully since those solutions bear a risk within themselves...
February 9, 2017: Der Internist
https://www.readbyqxmd.com/read/28183818/normalization-of-hemoglobin-based-oxygen-carrier-201-induced-vasoconstriction-roles-of-nitric-oxide-scavenging-and-endothelin
#8
Yannick J Taverne, Daphne P M de Wijs-Meijler, Maaike Te Lintel Hekkert, Paula F Moon-Massat, Greg P Dubé, Dirk Jan Duncker, Daphne Merkus
BACKGROUND: Hemoglobin-based oxygen carrier (HBOC)-201 is a cell-free modified hemoglobin solution potentially facilitating oxygen uptake and delivery in cardiovascular disorders and hemorrhagic shock. Clinical use has been hampered by vasoconstriction in the systemic and pulmonary beds. Therefore we aimed to 1) determine the possibility of counteracting HBOC-201-induced pressor effects with adenosine (ADO), 2) assess the potential roles of nitric oxide (NO) scavenging, reactive oxygen species (ROS) and endothelin (ET) in mediating the observed vasoconstriction and 3) compare these effects in resting and exercising swine...
February 9, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28164835/a-quick-reference-on-hyponatremia
#9
REVIEW
Julien Guillaumin, Stephen P DiBartola
The article focuses on causes of hyponatremia, including hypovolemia, diabetes mellitus and others. Hypovolemia is a major cause of hyponatremia in veterinary medicine. Hypovolemia causes a decrease in effective circulating volume, triggering antidiuretic hormone (ADH) secretion and free water retention, and develops after gastrointestinal losses, renal losses, hemorrhagic shock, hypoadrenocorticism, and other causes of hypovolemia. The article reviews the clinical approach to diagnosing the cause of hyponatremia in critically ill patients, including recognition of the syndrome of inappropriate ADH secretion (SIADH)...
March 2017: Veterinary Clinics of North America. Small Animal Practice
https://www.readbyqxmd.com/read/28163291/production-of-insulin-like-growth-factor-ii-in-hepatocellular-carcinoma-with-recurrent-hypoglycemia-a-case-report
#10
Rieko Nakata, Hirokazu Kadoya, Naoki Sugimura, Takayuki Katsuno, Kazuki Aomatsu, Tsuyoshi Hayakawa, Sawako Uchida-Kobayashi, Tetsuo Arakawa, Hideaki Miwa
A 35-year-old woman, who was an HBV carrier, complained of fever for 2 weeks, and thus, she was admitted in our hospital. Both serum AFP and PIVKA-II levels were abnormally high, and an abdominal enhanced CT revealed the presence of multiple masses in both lobes of the liver. She was diagnosed with hepatocellular carcinoma (T4, N0, M0, and Vp4) and was treated with transcatheter arterial infusion chemotherapy. On the 4th day of her illness, her serum glucose level was 26mg/dl. Glucose infusion and intravenous hyperalimentation were not effective, and she experienced repeated hypoglycemic attacks...
2017: Nihon Shokakibyo Gakkai Zasshi, the Japanese Journal of Gastro-enterology
https://www.readbyqxmd.com/read/28163177/venous-shunt-versus-venous-ligation-for-vascular-damage-control-the-immuno-histochemical-evidence
#11
Adenauer Marinho de Oliveira Góes Junior, Simone de Campos Vieira Abib, Maria Teresa de Seixas Alves, Paulo Sérgio Venerando da Silva Ferreira, Mariseth Carvalho de Andrade
OBJECTIVES: To evaluate the expression of immuno-histochemical markers of tissue ischemia (iNOS, eNOS and HSP70) in a vascular damage control experimental model in order to determine if a venous temporary vascular shunt insertion leads to a better limb perfusion when compared to the ligature of the injured vein. METHODS: Experimental study in male Sus Scrofa weighting 40 Kg. Animals were distributed into 5 groups: group 1 animals were submitted to right external iliac artery (EIA) shunting and right external iliac vein (EIV) ligation; group 2 animals were submitted to right EIA shunting and right EIV shunting; group 3 animals were submitted to right EIV ligation; group 4 animals were submitted to right EIV shunting; group 5 animals were not submitted to vascular shunting nor venous ligation...
February 2, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28161256/cecal-perforation-associated-with-clostridium-difficile-infection-a%C3%A2-case-report
#12
Sarah Kyuragi Luthe, Ryota Sato
BACKGROUND: Various complications are reported with Clostridium difficile infection (CDI), including fulminant CDI. Fulminant CDI is an underappreciated life-threatening condition associated with complications such as toxic megacolon and bowel perforation. CASE REPORT: A 79-year-old woman presented to the Emergency Department with altered mental status. She was admitted and conservatively treated for a left thalamic hemorrhage. While hospitalized, she developed watery diarrhea due to Clostridium difficile...
February 2, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28160976/global-outcome-in-patients-with-left-ventricular-assist-devices
#13
Timothy J Fendler, Michael E Nassif, Kevin F Kennedy, Susan M Joseph, Scott C Silvestry, Gregory A Ewald, Shane J LaRue, Justin M Vader, John A Spertus, Suzanne V Arnold
Left ventricular assist devices (LVADs) improve survival and quality of life (QOL) for most, but not all, patients with advanced heart failure. We described a broader definition of poor outcomes after LVAD, using a novel composite of death, QOL, and other major adverse events. We evaluated the frequency of poor global outcome at 1 year after LVAD among 164 patients (86% Interagency Registry for Mechanically Assisted Circulatory Support profile 1 to 2; shock or declining despite inotropes) at a high-volume center...
January 5, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28159434/-and-if-it-happened-to-children-adapting-medical-care-during-terrorist-attacks-with-multiple-pediatric-victims
#14
L Alix-Séguin, N Lodé, G Orliaguet, E Chamorro, F Kerroué, C Lorge, A Moreira
In light of the recent terrorist attacks in Europe, we need to reconsider the organization of rescue and medical management and plan for an attack involving multiple pediatric victims. To ensure quick surgical management, but also to minimize risk for on-site teams (direct threats from secondary terrorist attacks targeting deployed emergency services), it is crucial to evacuate patients in a swift but orderly fashion. Children are vulnerable targets in terrorist attacks. Their anatomical and physiological characteristics make it likely that pediatric victims will suffer more brain injuries and require more, often advanced, airway management...
January 31, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28148289/a-rare-case-of-dengue-encephalopathy-complicating-a-term-pregnancy
#15
Lavanya Rajagopala, Ravindra L Satharasinghe, Madhava Karunarathna
BACKGROUND: Dengue fever has an expanded clinical spectrum ranging from an asymptomatic infection to life threatening dengue hemorrhagic fever and refractory shock. Dengue infection in pregnancy can be a diagnostic dilemma, particularly considering the physiological changes in pregnancy and the obstetric complications encountered in clinical practice. Hence the knowledge of its diagnosis and management in its atypical presentations is of paramount importance. Here we report an unusual case of uncomplicated dengue encephalopathy in a term mother, probably the first to be reported from the Indian subcontinent...
February 2, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28144845/gastric-vascular-and-motor-responses-to-anaphylactic-hypotension-in-anesthetized-rats-in-comparison-to-those-with-hemorrhagic-or-vasodilator-induced-hypotension
#16
Yuhichi Kuda, Toshishige Shibamoto, Tao Zhang, Wei Yang, Mamoru Tanida, Yasutaka Kurata
Anaphylactic shock is life-threatening, but pathophysiology of the stomach lesion remains unclear. We determined gastric hemodynamics and gastric functions during anaphylactic hypotension, as compared to hypotension induced by hemorrhage or sodium nitroprusside (SNP) in anesthetized and ovalbumin-sensitized Sprague-Dawley rats. Systemic arterial pressure, portal venous pressure, and gastric arterial blood flow were measured, and gastric vascular resistance (GVR) was determined. Separately, the intragastric pressure (IGP) and gastric effluent, as a measure of gastric flux, were continuously measured...
January 31, 2017: Journal of Physiological Sciences: JPS
https://www.readbyqxmd.com/read/28143591/a-case-report-of-intravenous-posaconazole-in-hepatic-and-renal-impairment-patient-with-invasive-aspergillus-terreus-infection-safety-and-role-of-therapeutic-drug-monitoring
#17
Pitchaya Dilokpattanamongkol, Panadda Panusitthikorn, Rasda Boonprasert, Methee Chayakulkeeree, Porpon Rotjanapan
BACKGROUND: Invasive aspergillosis (IA) is a fatal infectious complication among immunocompromised patients. Aspergillus terreus, the fourth common species can be difficult to treat due to a unique resistance pattern. To date, there has been no report on safety and dose adjustment when intravenous posaconazole is selected in hepatic and renal impairment patient. We present a rare case of intravenous posaconazole use in a hepatic and renal impairment patient with invasive A. terreus pulmonary infection...
January 31, 2017: BMC Pharmacology & Toxicology
https://www.readbyqxmd.com/read/28137229/challenges-with-mosquito-borne-viral-diseases-outbreak-of-the-monsters
#18
Renu Gautam, Sweta Mishra, Archana Milhotra, Ritika Nagpal, Mradul Mohan, Anchal Singhal, Pratibha Kumari
The viruses responsible for mosquito-borne diseases are on an exploring mode, expanding their horizon, adapting to the situation and comfortably making their presence felt globally, from South Africa to Asia, Europe and United States. The current global scenario and recent documentations indicate towards the real monsters, outbreak of Zika, dengue and chikungunya viruses. Zika, dengue and chikungunya viruses, all three are positive sense single-stranded RNA arbovirus and so their initial symptoms are almost 80% similar and all three are spread by mosquitos which bite during the day...
January 30, 2017: Current Topics in Medicinal Chemistry
https://www.readbyqxmd.com/read/28135676/horizontal-traumatic-laceration-of-the-pancreas-head-a-rare-case-report
#19
Atsushi Nanashima, Naoya Imamura, Yuki Tsuchimochi, Takeomi Hamada, Kouichi Yano, Masahide Hiyoshi, Yoshiro Fujii, Fumiaki Kawano, MitsuruTamura
INTRODUCTION: This case report is intended to inform acute care surgeons about treating rare horizontal laceration of the pancreas head caused by blunt trauma. CASE PRESENTATION: A 57-year-old woman who sustained blunt abdominal trauma during a car crash was transported to the emergency center of our hospital with unstable vital signs due to hemorrhagic shock. Computed tomography showed transection of the pancreas head and massive intra-abdominal hemorrhage. She was referred for emergency surgery because of a transient response...
January 17, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28129711/the-effect-of-ppolyhb-on-hemodynamic-stability-and-mesenteric-microcirculation-in-a-rat-model-of-hemorrhagic-shock
#20
Jing Zhao, Chengbin Yan, Lijuan Xu, Kunping Yan, Bao Feng, Mengye Zhao, Geng Niu, Mengdi Wu, Chao Chen, Hongli Zhu
The effects of polymerized porcine hemoglobin (pPolyHb) on hemodynamic stability and maintenance of mesenteric microvascular function were explored in a rat model of hemorrhagic shock (HS). Following controlled hemorrhage, rats were infused with equal volumes of either pPolyHb, hetastarch (HES), or red blood cell (RBC). The results showed that pPolyHb was superior to HES and RBC in restoring hemodynamic stability and reversing anaerobic metabolism. We observed a reduction in the diameter of mesenteric microvasculature after HS...
January 27, 2017: Artificial Cells, Nanomedicine, and Biotechnology
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