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https://www.readbyqxmd.com/read/28212620/clinical-manifestations-of-severe-enterovirus-71-infection-and-early-assessment-in-a-southern-china-population
#1
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/28183462/the-impact-of-excluding-shock-patients-on%C3%A2-hospital-and-physician-risk-adjusted-mortality-rates-for-percutaneous-coronary%C3%A2-interventions-the-implications-for-public-reporting
#2
Edward L Hannan, Ye Zhong, Kimberly Cozzens, Foster Gesten, Marcus Friedrich, Peter B Berger, Alice K Jacobs, Gary Walford, Frederick S K Ling, Ferdinand J Venditti, Spencer B King
OBJECTIVES: The authors examined the impact of including shock patients in public reporting of percutaneous coronary intervention (PCI) risk-adjusted mortality. BACKGROUND: There is concern that an unintended consequence of statewide public reporting of medical outcomes is the avoidance of appropriate interventions for high-risk patients. METHODS: New York State's PCI registry was used to compare hospital and physician risk-adjusted mortality rates and outliers from New York's public report models with rates and outliers based on statistical models that include refractory shock patients and exclude both refractory shock and other shock patients...
February 13, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28161219/terlipressin-in-refractory-shock-induced-by-diltiazem-poisoning
#3
Claire Ragot, Edouard Gerbaud, Alexandre Boyer
Poisoning caused by calcium-channels blockers (CCB) can cause refractory vasoplegic shock, resulting in multiple-organ failure and death despite maximal therapy including high doses of vasopressors. We report one CCB-induced refractory shock complicated with lactate acidosis despite very high doses of epinephrine and norepinephrine. The hemodynamic status of the patient dramatically improved after intermittent boluses of terlipressin, which corrected the acidosis.
January 27, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28161113/-myocarditis
#4
G Hékimian, A Combes
Acute myocarditis must be considered in patients with recent onset of cardiac failure or arrhythmia. Fulminant myocarditis is a distinct entity characterized by sudden onset of severe congestive heart failure or cardiogenic shock, usually following a flu-like illness, parvovirus B19, human herpesvirus 6, coxsackie virus and adenovirus being the most frequently viruses responsible for the disease. In this setting, early recognition of patients rapidly progressing to refractory cardiac failure and their immediate transfer to a medical-surgical center experienced in mechanical circulatory support is warranted...
February 1, 2017: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/28160364/peripheral-nerve-stimulation-of-brachial-plexus-nerve-roots-and-supra-scapular-nerve-for-chronic-refractory-neuropathic-pain-of-the-upper-limb
#5
Bénédicte Bouche, Marie Manfiotto, Philippe Rigoard, Jean Lemarie, Véronique Dix-Neuf, Michel Lanteri-Minet, Denys Fontaine
OBJECTIVES: We report the outcome of a consecutive series of 26 patients suffering from chronic medically-refractory neuropathic pain of the upper limb (including 16 patients with complex regional pain syndrome), topographically limited, treated by brachial plexus (BP) nerve roots or supra-scapular nerve (SSN) peripheral nerve stimulation (PNS). MATERIALS AND METHODS: The technique consisted in ultrasound-guided percutaneous implantation of a cylindrical lead (Pisces-Quad, Medtronic) close to the SSN or the cervical nerve roots within the BP, depending on the pain topography...
February 3, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28153551/current-and-future-percutaneous-strategies-for-the-treatment-of-acute-and-chronic-heart-failure
#6
Ignacio J Amat-Santos, Luis H Varela-Falcón, William T Abraham
The prevalence of heart failure (HF) has risen in parallel with improved survival in patients after a myocardial infarction and an aging population worldwide. In recent years, new percutaneous therapies have been developed to complement current established treatments for acute/decompensated and chronic HF and minimize risks. In acute presentations, the failure of medical treatment is no longer the end of the road in refractory circulatory shock; the use of mechanical circulatory support devices may be the next milestone in well-resourced health settings...
January 30, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/28148289/a-rare-case-of-dengue-encephalopathy-complicating-a-term-pregnancy
#7
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/28144392/vasopressin-use-in-critically-ill-cirrhosis-patients-with-catecholamine-resistant-septic-shock-the-cvicu-cohort
#8
Lukasz A Myc, Jonathan G Stine, Rinita Chakrapani, Alexandra Kadl, Curtis K Argo
AIM: To examine patient-centered outcomes with vasopressin (AVP) use in patients with cirrhosis with catecholamine-refractory septic shock. METHODS: We conducted a single center, retrospective cohort study enrolling adult patients with cirrhosis treated for catecholamine-resistant septic shock in the intensive care unit (ICU) from March 2011 through December 2013. Other etiologies of shock were excluded. Multivariable regression models were constructed for seven and 28-d mortality comparing AVP as a second-line therapy to a group of all other vasoactive agents...
January 18, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/28134658/flow-rate-through-pigtail-catheter-used-for-left-heart-decompression-in-an-artificial-model-of-extracorporeal-membrane-oxygenation-circuit
#9
Won Ho Kim, Tae Hee Hong, Joung Hun Byun, Jong Woo Kim, Sung Hwan Kim, Sung Ho Moon, Hyun Oh Park, Jun Young Choi, Jun Ho Yang, In Seok Jang, Chung Eun Lee, Jeong Hee Yun
In refractory cardiogenic shock, veno-arterial extracorporeal membrane oxygenation (ECMO) can be initiated. Although left heart decompression can be accomplished by insertion of a left atrial (LA) or LV cannula using a percutaneous pigtail catheter, the venting flow rate according to catheter size and ECMO flow rate is unknown. We developed an artificial ECMO circuit. 1L saline bag with its pressure set to 20 mmHg was connected to ECMO to mimic LV failure. A pigtail catheter was inserted into the 1 L saline bag to simulate LV unloading...
January 26, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28131429/venoarterial-extracorporeal-membrane-oxygenation-for-refractory-cardiogenic-shock-in-elderly-patients-trends-in-application-and-outcome-from-the-extracorporeal-life-support-organization-elso-registry
#10
Roberto Lorusso, Sandro Gelsomino, Orlando Parise, Priya Mendiratta, Parthak Prodhan, Peter Rycus, Graeme MacLaren, Thomas V Brogan, Yih-Sharng Chen, Jos Maessen, Xiaotong Hou, Ravi R Thiagarajan
BACKGROUND: Venoarterial extracorporeal membrane oxygenation (VA-ECMO) for refractory cardiogenic shock (RCS) is increasingly used in adult patients, but age represents a controversial factor in this setting. METHODS: Data from the Extracorporeal Life Support Organization registry was analyzed to assess in-hospital survival of elderly patients (≥70 years of age) undergoing VA-ECMO for RCS from 1992 to 2015. In-hospital survival and complications for elderly patients were compared with data in younger adults (≥18 to <70 years of age) supported with VA-ECMO during the same time period for similar indications...
January 25, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28127437/effect-of-extracorporeal-cytokine-removal-on-vascular-barrier-function-in-a-septic-shock-patient
#11
Sascha David, Kristina Thamm, Bernhard M W Schmidt, Christine S Falk, Jan T Kielstein
BACKGROUND: Sepsis and septic shock are major healthcare problems, affecting millions of individuals around the world each year. Pathophysiologically, septic multiple organ dysfunction (MOD) is a life-threatening condition caused by an overwhelming systemic inflammatory response of the host's organism to an infection. We experimentally tested if high circulating cytokine levels might increase vascular permeability-a critical hallmark of the disease-and if this phenomenon can be reversed by therapeutic cytokine removal (CytoSorb®) in an exemplary patient...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28119778/long-term-efficacy-of-extracorporeal-shock-wave-therapy-eswt-for-treatment-of-refractory-chronic-abacterial-prostatitis
#12
Ghazi Mohammad Al Edwan, Muheilan Mustafa Muheilan, Omar Nabeeh M Atta
OBJECTIVE: To evaluate the effect and safety of extracorporeal shockwave therapy (ESWT) on chronic pelvic pain syndrome (CPPS)/chronic abacterial prostatitis after failure of most other modalities of treatment, the maintenance of the treatment effect for up to one year post treatment and whether the patients are in need for further sessions. MATERIALS AND METHODS: In a follow-up survey of 41 patients, the study inclusion criteria were CPPS patients who failed at least previously 3 modalities of treatment other than ESWT, who were treated by ESWT once a week for one month with a protocol of 2500 pulses at 1 bar over 13 min, Nonaddiction to drugs and narcotics...
February 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28118806/refractory-patella-tendinopathy-with-failed-conservative-treatment-shock-wave-or-arthroscopy
#13
Hlm Williams, S A Jones, C Lyons, C Wilson, A Ghandour
AIM: To identify whether the location of refractory patella tendinopathy (PT) has an effect on treatment modality (radial extracorporeal shock wave therapy (rESWT) or arthroscopic debridement). METHODS: Between 2012 and 2014, 40 patients with PT underwent a magnetic resonance imaging (MRI) scan. This confirmed the diagnosis as either involving the tendon itself (group A, 20) or with retropatella fat pad extension (group B, 20). All patients underwent rESWT. If there was no improvement patients proceeded with surgery in the form of arthroscopic debridement (by senior authors CW and AG)...
January 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28106022/complicated-left-sided-infective-endocarditis-in-chronic-hemodialysis-patients-a-case-report
#14
Öykü Gülmez, Mehtap Aydın
Infective endocarditis (IE) is a serious infectious condition with high morbidity and mortality in patients with end-stage renal disease (ESRD). It has been particularly associated with recurrent bacteremia due to vascular access via lumen catheters. The most common pathogen is Staphylococcus (S.) aureus, and most affected valve is mitral valve, which frequently calcified. Two patients with ESRD who received hemodialysis treatment via tunneled catheters, aged 56 and 88 years, were admitted with fever and high troponin level...
January 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28099641/sepsis-related-acute-respiratory-distress-syndrome-in-children-with-cancer-the-respiratory-dynamics-of-a-devastating-condition
#15
Rodrigo Genaro Arduini, Orlei Ribeiro de Araujo, Dafne Cardoso Bourguignon da Silva, Andreza Almeida Senerchia, Antonio Sergio Petrilli
Objective: To evaluate the clinical course and respiratory parameters of mechanically ventilated children with cancer suffering from sepsis-related acute respiratory distress syndrome. Methods: This 2-year prospective, longitudinal, observational cohort study enrolled 29 children and adolescents. Clinical data, measurements of blood gases and ventilation parameters were collected at four different time points. Fluctuations between measurements as well as differences in estimated means were analyzed by linear mixed models in which death within 28 days from the onset of acute respiratory distress syndrome was the primary endpoint...
October 2016: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28096226/disseminated-adenovirus-infection-causing-severe-ards
#16
Steven J Campbell, Jessica A Kynyk, John A Davis
A previously healthy young man with a rare genetic condition presented with severe acute respiratory distress syndrome secondary to pneumonia with septic shock. He did not improve with conventional therapy for his known causal organism thus prompting further workup. He was found to be profoundly immunosuppressed raising our suspicion for atypical organisms. A bronchoalveolar lavage sample was positive via PCR for adenovirus which we suspect exacerbated a pre-existing bacterial pneumonia and led to a severe and non-responsive respiratory failure...
January 17, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28093621/outcome-of-elderly-undergoing-extracorporeal-life-support-in-refractory-cardiogenic-shock
#17
Suzanne de Waha, Tobias Graf, Steffen Desch, Georg Fuernau, Ingo Eitel, Janine Pöss, Alexander Jobs, Thomas Stiermaier, Jakob Ledwoch, Ariane Wiedau, Philipp Lurz, Gerhard Schuler, Holger Thiele
BACKGROUND: The current study presents data from a real-world cohort of patients with refractory cardiogenic shock (CS) undergoing extracorporeal life support (ECLS) focusing on the comparison of elderly versus younger patients. METHODS AND RESULTS: One hundred consecutive patients with refractory CS underwent percutaneous ECLS implantation performed by interventional cardiologists. Follow-up was performed at hospital discharge as well as at a median of 18 months [interquartile range 15-36]...
January 16, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/28074818/cannulation-strategies-in-adult-veno-arterial-and-veno-venous-extracorporeal-membrane-oxygenation-techniques-limitations-and-special-considerations
#18
Arun L Jayaraman, Daniel Cormican, Pranav Shah, Harish Ramakrishna
Extracorporeal membrane oxygenation (ECMO) refers to specific mechanical devices used to temporarily support the failing heart and/or lung. Technological advances as well as growing collective knowledge and experience have resulted in increased ECMO use and improved outcomes. Veno-arterial (VA) ECMO is used in selected patients with various etiologies of cardiogenic shock and entails either central or peripheral cannulation. Central cannulation is frequently used in postcardiotomy cardiogenic shock and is associated with improved venous drainage and reduced concern for upper body hypoxemia as compared to peripheral cannulation...
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28072930/left-ventricular-outflow-tract-obstruction-be-prepared
#19
J S Evans, S J Huang, A S McLean, M Nalos
The current trend to treat hypotension in critically ill patients is to place a greater emphasis on inotropic support and less on fluid resuscitation in order to limit the potential harm from fluid overload. This combination may trigger left ventricular outflow tract obstruction (LVOTO) in susceptible patients. Although LVOTO is classically described in patients with hypertrophic cardiomyopathy it has been reported in other conditions including septic shock, apical ballooning syndrome, myocardial infarction, respiratory failure, and post valvular surgery...
January 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28057037/role-of-vasopressin-and-terlipressin-in-refractory-shock-compared-to-conventional-therapy-in-the-neonatal-and-pediatric-population-a-systematic-review-meta-analysis-and-trial-sequential-analysis
#20
Reem Masarwa, Gideon Paret, Amichai Perlman, Shimon Reif, Bruria Hirsh Raccah, Ilan Matok
BACKGROUND: Vasopressin (AVP) and terlipressin (TP) have been used as last-line therapy in refractory shock in children. However, the efficacy and safety profiles of AVP and TP have not been determined in pediatric refractory shock of different origins. We aimed to assess the efficacy and safety of the addition of AVP/TP therapy in pediatric refractory shock of all causes compared to conventional therapy with fluid resuscitation and vasopressor and inotropic therapy. METHODS: We conducted a systematic review, meta-analysis, and trial sequential analysis (TSA) comparing AVP and TP to conventional therapy...
January 5, 2017: Critical Care: the Official Journal of the Critical Care Forum
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