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https://www.readbyqxmd.com/read/28822659/incidence-and-risk-factors-of-groin-lymphocele-formation-after-venoarterial-extracorporeal-membrane-oxygenation-in-cardiogenic-shock-patients
#1
Michael Salna, Hiroo Takayama, Arthur R Garan, Paul Kurlansky, Maryjane A Farr, Paolo C Colombo, Thomas Imahiyerobo, Nicholas Morrissey, Yoshifumi Naka, Koji Takeda
OBJECTIVE: Venous-arterial extracorporeal membrane oxygenation (VA-ECMO) is a well-established therapy for refractory cardiopulmonary failure. Femoral cannulation offers a quick and effective means of providing circulatory support but is not without complication. Inflammation or lymphatic disruption at the site of cannulation can cause the formation of lymphoceles, leading to the patient's discomfort and possibly necessitating intervention. The purpose of this study was to evaluate the incidence of in-hospital lymphocele formation in VA-ECMO patients and to identify predictors for their development...
August 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28821378/pathogens-and-outcomes-in-pediatric-septic-shock-patients-supported-by-extracorporeal-membrane-oxygenation
#2
Tu-Hsuan Chang, En-Ting Wu, Chun-Yi Lu, Shu-Chien Huang, Tzu-I Yang, Ching-Chia Wang, Jong-Min Chen, Ping-Ing Lee, Li-Min Huang, Luan-Yin Chang
BACKGROUND: Refractory septic shock is the leading cause of mortality in children. There is limited evidence to support extracorporeal membrane oxygenation (ECMO) use in pediatric septic shock. We described the etiology and outcomes of septic patients in our institution and attempted to find predictive factors. METHODS: We retrospectively reviewed 55 pediatric patients with septic shock who required ECMO support in a tertiary medical center from 2008 to 2015. Septic shock was defined as culture proved or clinical suspected sepsis with hypotension or end-organ hypoperfusion...
August 4, 2017: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
https://www.readbyqxmd.com/read/28818335/-usefulness-of-veno-arterial-ecmo-in-postsurgical-management-of-refractory-cardiogenic-shock-in-complex-aortic-disease
#3
Alejandra Rodríguez-Hernández, Carlos Adán-Brito, Gustavo Rojas-Velasco, Francisco Martín Baranda-Tovar
No abstract text is available yet for this article.
August 14, 2017: Archivos de Cardiología de México
https://www.readbyqxmd.com/read/28814247/fluid-and-medication-considerations-in-the-traumatized-patient
#4
Amita Misir
This article reviews fluid therapy and medications in pediatric trauma. For resuscitation in the setting of hemorrhagic shock, isotonic crystalloid solution is the first-line agent of choice. Colloid solutions offer no additional benefit, introduce possible increased risks and cost more than crystalloids. Blood products, starting with pRBCs, should be introduced after 20-40 ml/kg of crystalloid has been administered if there is ongoing need for volume replacement. The use of a massive transfusion protocol of 1:1:1 (if >30 kg) or 30:20:20 (if <30 kg) of pRBCs:FFP:platelets is suggested after an initial 30 ml/kg of pRBcs have been administered...
August 14, 2017: Current Pediatric Reviews
https://www.readbyqxmd.com/read/28806755/acquired-von-willebrand-syndrome-in-cardiogenic-shock-patients-on-mechanical-circulatory-microaxial-pump-support
#5
Ulrike Flierl, Jörn Tongers, Dominik Berliner, Jan-Thorben Sieweke, Florian Zauner, Christoph Wingert, Christian Riehle, Johann Bauersachs, Andreas Schäfer
Early use of mechanical circulatory support, e.g. veno-arterial extracorporeal membrane oxygenation (ECMO) or left ventricular unloading by microaxial pump in refractory cardiogenic shock is recommended in current guidelines. Development of acquired von Willebrand Syndrome (AVWS) in patients with left ventricular assist devices (LVADs) and ECMO has been reported. There is an increasing number of patients treated with the Impella® CP microaxial pump for left ventricular unloading. However, the prevalence of AVWS in these high risk patients is unknown and needs to be determined...
2017: PloS One
https://www.readbyqxmd.com/read/28802656/rethinking-papillary-muscle-resection-for-refractory-ventricular-tachycardia-in-the-lvad-era-a-case-report
#6
Zachary J Il'Giovine, Adam D DeVore, Chetan B Patel, Jason Koontz, Jacob Schroder
We report the case of a 57-year-old man with a history of ischemic cardiomyopathy who presented to the hospital with recurrent episodes of ventricular tachycardia refractory to antiarrhythmic medications. Mapping identified a deep premature ventricular contraction focus in the anterolateral papillary muscle, an area that has been previously identified as difficult to treat with radiofrequency catheter ablation. The hospital course was complicated by cardiogenic shock and VT-storm, and the patient ultimately underwent surgical resection of the anterolateral papillary muscle with left ventricular assist device placement as a successful bridge to cardiac transplantation...
July 12, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28801325/aluminium-phosphide-poisoning-with-severe-cardiac-dysfunction-and-the-role-of-digoxin
#7
Khalid Hamid Changal, Muzamil Latief, Manzoor Parry, Farhat Abbas
Aluminium phosphide (ALP) is a common cause of suicidal poisoning in India where it is easily available and commonly known as 'rice tablet'. In rural areas of India, it is still used to protect rice and stored grains from rodents and pests. (1) There is no specific antidote for phosphide poisoning and treatment involves meticulous supportive care. Ingestion can lead to severe cardiac suppression and cardiogenic shock. For patients poisoned with ALP who continue to have refractory shock with persistent myocardial suppression despite the use of adrenergic inotropic agents, the addition of digoxin may be beneficial...
August 11, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28800777/bortezomib-treatment-induces-a-higher-mortality-rate-in-lupus-model-mice-with-a-higher-disease-activity
#8
Tomoko Ikeda, Hiroshi Fujii, Masato Nose, Yukiko Kamogawa, Tsuyoshi Shirai, Yuko Shirota, Tomonori Ishii, Hideo Harigae
BACKGROUND: Bortezomib (Bz) is a proteasome inhibitor that directly targets antibody-producing plasma cells. We recently reported the first randomized control trial that evaluated the effects of Bz in patients with systemic lupus erythematosus (SLE). In that study, we demonstrated that Bz treatment is associated with many adverse reactions in patients with refractory disease. In the present study, we examine the therapeutic and toxic effects of Bz on MRL/MpJ-lpr/lpr (MRL/lpr) mice with severe disease activity...
August 11, 2017: Arthritis Research & Therapy
https://www.readbyqxmd.com/read/28789991/potential-impact-of-a-prehospital-redirection-system-for-refractory-cardiac-arrest
#9
Alexis Cournoyer, Éric Notebaert, Luc de Montigny, Sylvie Cossette, Luc Londei-Leduc, Massimiliano Iseppon, Yoan Lamarche, Catalina Sokoloff, Judy Morris, Éric Piette, Raoul Daoust, Jean-Marc Chauny, Dave Ross, Dominique Lafrance, Eli Segal, Yiorgos Alexandros Cavayas, Jean Paquet, André Denault
AIM: A change in prehospital redirection practice could potentially increase the proportion of E-CPR eligible patients with out-of-hospital cardiac arrest (OHCA) transported to extracorporeal cardiopulmonary resuscitation (E-CPR) capable centers. The objective of this study was to quantify this potential increase of E-CPR candidates transported to E-CPR capable centers. METHODS: Adults with non-traumatic OHCA refractory to 15min of resuscitation were selected from a registry of adult OHCA collected between 2010 and 2015 in Montreal, Canada...
August 5, 2017: Resuscitation
https://www.readbyqxmd.com/read/28764748/a-phase-i-trial-of-ganetespib-in-combination-with-paclitaxel-and-trastuzumab-in-patients-with-human-epidermal-growth-factor-receptor-2-her2-positive-metastatic-breast-cancer
#10
Komal Jhaveri, Rui Wang, Eleonora Teplinsky, Sarat Chandarlapaty, David Solit, Karen Cadoo, James Speyer, Gabriella D'Andrea, Sylvia Adams, Sujata Patil, Sofia Haque, Tara O'Neill, Kent Friedman, Francisco J Esteva, Clifford Hudis, Shanu Modi
BACKGROUND: Targeted therapies in HER2-positive metastatic breast cancer significantly improve outcomes but efficacy is limited by therapeutic resistance. HER2 is an acutely sensitive Heat Shock Protein 90 (HSP90) client and HSP90 inhibition can overcome trastuzumab resistance. Preclinical data suggest that HSP90 inhibition is synergistic with taxanes with the potential for significant clinical activity. We therefore tested ganetespib, a HSP90 inhibitor, in combination with paclitaxel and trastuzumab in patients with trastuzumab-refractory HER2-positive metastatic breast cancer...
August 2, 2017: Breast Cancer Research: BCR
https://www.readbyqxmd.com/read/28758605/rescue-extracorporeal-membrane-oxygenation-therapy-in-methamphetamine-toxicity
#11
Laura K Morrison, J Kromm, J Gaudet, D Zuege, B Button, F Warshawski, S N Lucyk
Complications related to methamphetamine use and abuse are common presentations seen in the emergency department. Standard management focuses on addressing the central nervous system and cardiovascular effects with the use of sedation and hemodynamic support. We describe a case report of a patient with methamphetamine toxicity and subsequent severe cardiomyopathy refractory to conventional management that responded to cardiovascular support with extracorporeal membrane oxygenation therapy (ECMO). A 22-year-old female was admitted in severe cardiogenic shock following intravenous administration of methamphetamine and oral fentanyl use...
July 31, 2017: CJEM
https://www.readbyqxmd.com/read/28748192/extranodal-nk-t-cell-lymphoma-nasal-type-presenting-as-refractory-pseudomonas-aeruginosa-facial-cellulitis
#12
Erika Reategui Schwarz, Katerina G Oikonomou, Megan Reynolds, Juliette Kim, Rajeev L Balmiki, Stephanie A Sterling
Extranodal natural killer T-cell lymphoma, nasal type (ENKL), formerly called lethal midline granuloma or angiocentric T-cell lymphoma, is a predominantly extranodal non-Hodgkin lymphoma characterized by vascular damage, necrosis, and an association with Epstein-Barr virus. In the United States, it is more frequently seen in Asian, Asian Pacific Islander, and Hispanic descent populations and is more prevalent in males in their fifth decade. Clinical presentation of NK nasal lymphoma most commonly involves epistaxis; obstruction; discharge; destructive mass in sinuses, palate, and nose; and skin ulceration...
July 2017: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28741848/pharmacologic-considerations-in-the-management-of-patients-receiving-left-ventricular-percutaneous-mechanical-circulatory-support
#13
J Erin Allender, Brent N Reed, Jenna L Foster, Jeremy D Moretz, Carrie S Oliphant, Douglas L Jennings, Robert J DiDomenico, James C Coons
Percutaneous mechanical circulatory support (MCS) devices, including the intra-aortic balloon pump, Impella, and TandemHeart, are often used for hemodynamic support in the setting of refractory cardiogenic shock. The thrombotic and bleeding complications associated with these devices is well recognized, and the Impella and TandemHeart devices have unique anticoagulation considerations that may influence patient outcomes. Both devices typically require use of a heparinized purge solution in combination with intravenous unfractionated heparin, thereby providing multiple sources of heparin exposure...
July 25, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28731175/heat-shock-induced-hikeshi-protects-cell-viability-via-nuclear-translocation-of-heat-shock-protein-70
#14
Toru Yanoma, Kyoichi Ogata, Takehiko Yokobori, Munenori Ide, Erito Mochiki, Yoshitaka Toyomasu, Mitsuhiro Yanai, Norimichi Kogure, Akiharu Kimura, Masaki Suzuki, Nobuhiro Nakazawa, Tuya Bai, Tetsunari Oyama, Takayuki Asao, Ken Shirabe, Hiroyuki Kuwano
Heat shock proteins (HSPs), particularly HSP70, help restore normal cellular function following damage caused by stressors. HSP expression in tumor tissues indicates cancer progression, and while the development of HSP inhibitors is progressing, these substances are not widely used to treat cancer. HIKESHI (C11orf73) does not control the intracellular movement of HSP70 at normal temperatures; however, it does regulate the function and movements of HSP70 during heat shock. In this study, we examined the intracellular movement of HSP70 during heat shock to investigate the significance of HIKESHI expression in gastric cancer (GC) and determine if HIKESHI inhibition has cytotoxic effects...
July 21, 2017: Oncology Reports
https://www.readbyqxmd.com/read/28721212/recent-advances-in-the-management-of-ventricular-tachyarrhythmias
#15
REVIEW
Syeda Atiqa Batul, Brian Olshansky, John D Fisher, Rakesh Gopinathannair
Ventricular arrhythmias are an important cause of cardiovascular morbidity and mortality, particularly in those with structural heart disease, inherited cardiomyopathies, and channelopathies. The goals of ventricular arrhythmia management include symptom relief, improving quality of life, reducing implantable cardioverter defibrillator shocks, preventing deterioration of left ventricular function, reducing risk of arrhythmic death, and potentially improving overall survival. Guideline-directed medical therapy and implantable cardioverter defibrillator implantation remain the mainstay of therapy to prevent sudden cardiac death in patients with ventricular arrhythmias in the setting of structural heart disease...
2017: F1000Research
https://www.readbyqxmd.com/read/28718889/veno-arterial-extracorporeal-membrane-oxygenation-support-in-patients-undergoing-aortic-surgery
#16
Zhaopeng Zhong, Chunjing Jiang, Feng Yang, Xing Hao, Jialin Xing, Hong Wang, Xiaotong Hou
Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is an option for mechanical support for patients with postcardiotomy cardiogenic shock (PCS). However, the use of VA-ECMO in patients suffering from aortic disease with PCS has not been greatly reported. This is a retrospective review of adult patients undergoing aortic surgery who received VA-ECMO support to treat refractory PCS from August 2009 to May 2016. A total of 36 patients who underwent aortic surgery with VA-ECMO support for refractory PCS were included...
July 18, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28716039/extra-corporeal-membrane-oxygenation-for-refractory-cardiogenic-shock-after-adult-cardiac-surgery-a-systematic-review-and-meta-analysis
#17
Maziar Khorsandi, Scott Dougherty, Omar Bouamra, Vasudev Pai, Philip Curry, Steven Tsui, Stephen Clark, Stephen Westaby, Nawwar Al-Attar, Vipin Zamvar
BACKGROUND: Postcardiotomy cardiogenic shock (PCCS) refractory to inotropic support and intra-aortic balloon pump (IABP) occurs rarely but is almost universally fatal without mechanical circulatory support. In this systematic review and meta-analysis we looked at the evidence behind the use of veno-arterial extra-corporeal membrane oxygenation (VA ECMO) in refractory PCCS from a patient survival rate and determinants of outcome viewpoint. METHODS: A systematic review was performed in January 2017 using PubMed (with no defined time period) using the keywords "postcardiotomy", "cardiogenic shock", "extracorporeal membrane oxygenation" and "cardiac surgery"...
July 17, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28715720/extreme-dilatation-of-the-interposed-jejunal-pouch-after-proximal-gastrectomy-associated-with-portal-venous-gas-a-case-report
#18
Michinaga Takahashi, Shinji Goto, Tatsuya Ueno, Kentaro Shima, Koetsu Inoue, Daisuke Douchi, Orie Nishina, Hiroo Naito
INTRODUCTION: The jejunal pouch interposition (JPI) after proximal gastrectomy (PG) was proposed as a reconstructive procedure to provide a gastric reservoir substitute and prevent postgastrectomy syndrome. However, food residue remaining in some of the pouches resulted in the adverse effect of abdominal bloating, thereby body weight loss. Here, we report a rare case with an extreme dilation of the interposed jejunal pouch (JP) 8 years after PG, requiring pouch resection. PRESENTATION OF CASE: A 65-year-old-man who had undergone PG with an inverted U-shaped JPI for early gastric cancer 8 years previously, suffered from shock after right hip joint implantation...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28710236/complement-factor-b-mutation-associated-ahus-and-myocardial-infarction
#19
Natália Noronha, Filipa Dias Costa, Andrea Dias, Alexandra Dinis
A 6-month-old female infant was referred with a 3-day history of low-grade fever, slight nasal congestion and rhinorrhoea. On admission, the clinical findings were unremarkable and she was discharged home. However, she became progressively more listless with a decreased urine output and was once again seen in the emergency department. Analytically she was found to have metabolic acidosis, hyperkalaemia, thrombocytopaenia, anaemia and schistocytes in the peripheral blood smear. Based on these findings, the diagnosis of haemolyticâ-uremic syndrome was made...
July 14, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28704111/incomplete-dabigatran-reversal-with-idarucizumab
#20
Aaron P Steele, Jin A Lee, William E Dager
CONTEXT: With increasing use of direct oral anticoagulants (DOACs), urgent reversal of these agents becomes a growing concern. Idarucizumab is a humanized monoclonal antibody fragment that specifically binds to dabigatran with higher affinity than thrombin, rapidly neutralizing its anticoagulant effect without increased risk of thrombosis. CASE DETAILS: We describe two cases in which the recommended dose of idarucizumab was unsuccessful in completely reversing the anticoagulant effects of dabigatran...
July 13, 2017: Clinical Toxicology
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