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https://www.readbyqxmd.com/read/28743338/-clinical-characteristics-and-prognosis-in-patients-with-high-plasma-level-of-procalcitonin-an-analysis-in-188-patients
#1
Chuli Pan, Wei Cui, Feifei Zhou, Junwei Tu, Xiuhui Lin, Libin Li, Gensheng Zhang
OBJECTIVE: To investigate the clinical characteristics and prognosis of patients with high level of plasma procalcitonin (PCT > 100 μg/L), and to improve the clinician's understanding, diagnosis and treatment of this kind of patients. METHODS: A retrospective study was conducted. The clinical data of patients with plasma PCT over 100 μg/L within 48 hours of admission admitted to Second Affiliated Hospital of Zhejiang University School of Medicine from February 2013 to December 2016 were collected, and the clinical characteristics were analyzed...
July 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28742838/identification-of-novel-antigen-candidates-for-a-tuberculosis-vaccine-in-the-adult-zebrafish-danio-rerio
#2
Henna Myllymäki, Mirja Niskanen, Kaisa Ester Oksanen, Eleanor Sherwood, Maarit Ahava, Mataleena Parikka, Mika Rämet
Tuberculosis (TB) remains a major global health challenge and the development of a better vaccine takes center stage in fighting the disease. For this purpose, animal models that are capable of replicating the course of the disease and are suitable for the early-stage screening of vaccine candidates are needed. A Mycobacterium marinum infection in adult zebrafish resembles human TB. Here, we present a pre-clinical screen for a DNA-based tuberculosis vaccine in the adult zebrafish using an M. marinum infection model...
2017: PloS One
https://www.readbyqxmd.com/read/28741014/post-resuscitation-care
#3
Sohil Pothiawala
Following return of spontaneous circulation (ROSC) after cardiac arrest, the challenge is to institute measures that ensure a higher likelihood of neurologically intact survival. Regardless of the cause of collapse, multiple organ systems may be affected secondary to post-cardiac arrest syndrome. Interventions required for post-ROSC care are bundled into a care regimen: prompt identification and treatment of the cause of cardiac arrest; and treatment of electrolyte abnormalities. It is also essential to establish definitive airway management to maintain normocapnic ventilation, prevent hyperoxia, and optimise haemodynamic management via judicious intravenous fluids and vasoactive drugs...
July 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28741004/seventeen-years-of-life-support-courses-for-nurses-where-are-we-now
#4
Kenneth Heng, Fong Chi Wee
The Life Support Course for Nurses (LSCN) equips nurses with the resuscitation skills to be first responders in in-hospital cardiac arrests. Seventeen years after the initiation of the LSCN, a confidential cross-sectional Qualtrics™ survey was conducted in May 2016 on LSCN graduands to assess the following: confidence in nurse-initiated resuscitation post-LSCN; defibrillation experience and outcomes; and perceived barriers and usefulness of the LSCN. The majority of respondents reported that the course was useful and enhanced their confidence in resuscitation...
July 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28741002/extracorporeal-membrane-oxygenation-in-cardiac-arrest
#5
Boon Kiat Kenneth Tan
The survival of cardiac arrest patients is dependent on the efficient and timely application of the chain of survival. This includes early identification of cardiac arrest and activation of the emergency response system, high-quality cardiopulmonary resuscitation (CPR), rapid defibrillation, basic and advanced medical services, and advanced life support and post-cardiac arrest care. However, some patients may be refractory to these measures. Extracorporeal membrane oxygenation CPR (ECPR), otherwise known as extracorporeal life support, offers an alternative to such refractory cardiac arrest cases...
July 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28740999/advanced-cardiac-life-support-2016-singapore-guidelines
#6
Chi Keong Ching, Siew Hon Benjamin Leong, Siang Jin Terrance Chua, Swee Han Lim, Kenneth Heng, Sohil Pothiawala, Venkataraman Anantharaman
The main areas of emphasis in the Advanced Cardiac Life Support (ACLS) guidelines are: early recognition of cardiac arrest and call for help; good-quality chest compressions; early defibrillation when applicable; early administration of drugs; appropriate airway management ensuring normoventilation; and delivery of appropriate post-resuscitation care to enhance survival. Of note, it is important to monitor the quality of the various care procedures. The resuscitation team needs to reduce unnecessary interruptions to chest compressions in order to maintain adequate coronary perfusion pressure during the ACLS drill...
July 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28740998/therapeutic-temperature-management-ttm-post-resuscitation-care-for-adult-cardiac-arrest-with-recommendations-from-the-national-ttm-workgroup
#7
Siew Hon Benjamin Leong, Enoch Chan, Benjamin Choon Heng Ho, Colin Yeo, Sennen Lew, Duu Wen Sewa, Shir Lynn Lim, Chee Wan Lee, Pow Li Chia, Tien Siang Eric Lim, Eng Kiang Lee, Marcus Eng Hock Ong
Therapeutic temperature management (TTM) was strongly recommended by the 2015 International Liaison Committee on Resuscitation as a component of post-resuscitation care. It has been known to be effective in improving the survival rate and neurologic functional outcome of patients after cardiac arrest. In an effort to increase local adoption of TTM as a standard of post-resuscitation care, this paper discusses and makes recommendations on the treatment for local providers.
July 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28740632/psychological-effects-on-patient-s-relatives-regarding-their-presence-during-resuscitation
#8
Hassan Soleimanpour, Jafar Sadegh Tabrizi, Asghar Jafari Rouhi, Samad Ej Golzari, Ata Mahmoodpoor, Robab Mehdizadeh Esfanjani, Maryam Soleimanpour
Introduction: Presence of family and patients' relatives throughout resuscitation procedure is one of the most challenging concerns. Methods: In an interventional (quasi-experimental) study that was conducted during a 6 months period, the patients' relatives were randomly divided into two groups of intervention (the relatives who were eager to be present throughout the resuscitation procedure- under the family protection protocol, all of the procedure steps were explained to the relatives by an expert nurse who was not involved in the resuscitation procedure and control group (those who were not invited routinely to be present throughout the resuscitation procedure...
2017: Journal of Cardiovascular and Thoracic Research
https://www.readbyqxmd.com/read/28737312/life-after-the-event-a-review-of-basic-life-support-training-for-parents-following-apparent-life-threatening-events-and-their-experience-and-practices-following-discharge
#9
W L Macken, N Clarke, M Nadeem, D Coghlan
Apparent Life-Threatening Events (ALTEs) are a common presentation to paediatric hospitals and represent a significant cause of parental anxiety. Basic Life Support (BLS) training is recommended for all caregivers following ALTEs. This study aimed to assess the rate of caregiver BLS training and reviewed parents experience following discharge. Parents were interviewed by phone following discharge. Over the study period 25 children attended the Emergency Department with ALTE, 17/25 (68%) were trained and 13/17 (76%) were contactable for interview...
May 10, 2017: Irish Medical Journal
https://www.readbyqxmd.com/read/28737073/bleeding-pelvic-fracture-patients-evolution-of-resuscitation-protocols
#10
T Söderlund, T Ketonen, L Handolin
BACKGROUND AND AIMS: Massive transfusion protocol seems to improve outcome in massively bleeding trauma patients, but not pelvic fracture patients. The aim of this study was to evaluate the effect of massive transfusion protocol on the mortality and fluid resuscitation of shocked pelvic fracture patients. MATERIAL AND METHODS: This is a trauma register study from a single hospital. From the trauma registry patients with pelvic fracture, injury severity score >15, admission base excess below -5, age >15 years, blunt trauma, and primary admission from the scene were identified...
March 1, 2017: Scandinavian Journal of Surgery: SJS
https://www.readbyqxmd.com/read/28735650/prognostic-utility-of-neuroinjury-biomarkers-in-post-out-of-hospital-cardiac-arrest-ohca-patient-management
#11
S S Gul, K W Huesgen, K K Wang, K Mark, J A Tyndall
Despite aggressive intervention, patients who survive an out-of-hospital cardiac arrest (OHCA) generally have very poor prognoses, with nationwide survival rates of approximately 10-20%. Approximately 90% of survivors will have moderate to severe neurological injury ranging from moderate cognitive impairment to brain death. Currently, few early prognostic indicators are considered reliable enough to support patients' families and clinicians' in their decisions regarding medical futility. Blood biomarkers of neurological injury after OHCA may be of prognostic value in these cases...
August 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/28734628/adrenergic-receptor-genotypes-influence-postoperative-outcomes-in-infants-in-the-single-ventricle-reconstruction-trial
#12
Ronand Ramroop, George Manase, Danny Lu, Dorin Manase, Shan Chen, Richard Kim, Teresa Lee, William T Mahle, Kimberly McHugh, Mike Mitchell, Martin Tristani-Firouzi, Stephanie B Wechsler, Nicole S Wilder, Victor Zak, Myriam Lafreniere-Roula, Jane W Newburger, J William Gaynor, Mark W Russell, Seema Mital
OBJECTIVES: Adrenergic receptor (ADR) genotypes have been associated with adverse outcomes in heart failure. Our objective was to evaluate the association of ADR genotypes with post-Norwood outcomes in infants with hypoplastic left heart syndrome (HLHS). METHODS: Infants with HLHS participating in the Pediatric Heart Network Single-Ventricle Reconstruction Trial underwent genotyping for 4 single-nucleotide polymorphisms in 3 ADR genes: ADRB1_231A/G, ADRB1_1165G/C, ADRB2_5318C/G, and ADRA2A_2790C/T...
June 24, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28734575/outcomes-associated-to-serum-phosphate-levels-in-patients-with-suspected-acute-coronary-syndrome
#13
Hong Xu, Marie Evans, Alessandro Gasparini, Karolina Szummer, Jonas Spaak, Johan Ärnlöv, Bengt Lindholm, Tomas Jernberg, Juan Jesús Carrero
BACKGROUND: We investigated the association between phosphate and the risk of adverse clinical outcomes in patients with manifest cardiovascular disease (CVD). METHODS: Observational study of patients hospitalized during 2006-2011 in Stockholm, Sweden, because of suspected acute coronary syndrome (ACS). The exposure was serum phosphate during the hospitalization. We modeled the association between phosphate and in-hospital death or in-hospital events (composite of myocardial infarction, cardiogenic shock, resuscitated cardiac arrest, atrial fibrillation, or atrioventricular block) as well as the one-year post-discharge risk of death or cardiovascular event (composite of myocardial re-infarction, heart failure and stroke)...
July 17, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28728194/-relevance-of-living-wills-during-post-resuscitation-care
#14
Martin Christ, Katharina Isabel von Auenmüller, Martin Grett, Scharbanu Amirie, Michael Brand, Hans-Joachim Trappe
Background There is hardly any evidence about the influence of living wills on acute life-threatening disease like out-of-hospital cardiac-arrest (OHCA). We therefore initiated this study to quantify the percentage of victims of OHCA who's living wills are available during post-resuscitation care. Methods All victims of OHCA who were admitted to our hospital between January 1(st) 2008 and July 31(th) 2016 were identified by analysis of our central admission register. Data from individual patients were collected from the patient's health records and anonymously stored on a central database...
July 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28727610/the-metabolopathy-of-tissue-injury-hemorrhagic-shock-and-resuscitation-in-a-rat-model
#15
Anne L Slaughter, Geoffrey R Nunns, Angelo D'Alessandro, Anirban Banerjee, Kirk C Hansen, E E Moore, Christopher C Silliman, Travis Nemkov, Hunter B Moore, Miguel Fragoso, Kiara Leasia, Erik D Peltz
INTRODUCTION: The metabolic consequences of trauma induce significant clinical pathology. In this study we evaluate the independent, metabolic contributions of tissue injury (TI) and combined tissue injury and hemorrhagic shock (TI / HS) using MS-metabolomics in a controlled animal model of critical injury. METHODS: Sprague-Dawley rats (n = 14) underwent TI alone or TI / HS, followed by resuscitation with normal saline and shed blood. Plasma was collected (baseline, post-laparotomy, post-HS, post-resuscitation) for Ultra High Pressure Liquid Chromatography (UHPLC) MS-metabolomics...
July 19, 2017: Shock
https://www.readbyqxmd.com/read/28724904/hypertonic-saline-infusion-suppresses-apoptosis-of-hippocampal-cells-in-a-rat-model-of-cardiopulmonary-resuscitation
#16
Xiang Zhou, Yong Liu, Yang Huang, ShuiBo Zhu, Jian Zhu, RongPing Wang
Hypertonic saline (HS) attenuates cerebral edema, improves microcirculation perfusion and alleviates inflammation. However, whether the beneficial effect of HS on neurological function after cardiopulmonary resuscitation (CPR) in rat model of asphyxial cardiac arrest (CA) is mediated via attenuating apoptosis of neurons is not known. We studied the neuroprotective effect of HS in rats after CA and CPR, and explored the likely underlying mechanisms. Animals were randomly assigned to 4 equal groups (n = 15 each) according to the different infusions administered during resuscitation: control (C), normal saline (NS), hypertonic saline (HS), and hydroxyethyl starch (HES) groups...
July 19, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28723841/military-civilian-partnership-in-device-innovation-development-commercialization-and-application-of-resuscitative-endovascular-balloon-occlusion-of-the-aorta-reboa
#17
Todd E Rasmussen, Jonathan L Eliason
Noncompressible torso hemorrhage (NCTH) and shock is a leading cause of trauma-related mortality and evidence suggests that survival from this injury pattern has not improved in decades. As such, innovating new approaches and devices, including technologies which can be used by providers within a short of time after severe injury, is a priority for the military. Guided by wartime observations, and through partnerships with civilian academia and private investment, the military has led an effort to define resuscitative endovascular balloon occlusion of the aorta (REBOA) and assess its potential to address this problem...
July 19, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28717778/retention-of-cardiopulmonary-resuscitation-skills-after-hands-only-training-versus-conventional-training-in-novices-a-randomized-controlled-trial
#18
Young Joon Kim, Youngsuk Cho, Gyu Chong Cho, Hyun Kyung Ji, Song Yi Han, Jin Hyuck Lee
OBJECTIVE: Cardiopulmonary resuscitation (CPR) training can improve performance during simulated cardiac arrest; however, retention of skills after training remains uncertain. Recently, hands-only CPR has been shown to be as effective as conventional CPR. The purpose of this study is to compare the retention rate of CPR skills in laypersons after hands-only or conventional CPR training. METHODS: Participants were randomly assigned to 1 of 2 CPR training methods: 80 minutes of hands-only CPR training or 180 minutes of conventional CPR training...
June 2017: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/28716775/acute-rehabilitation-after-resuscitative-endovascular-balloon-occlusion-of-the-aorta-reboa-in-major-trauma
#19
Jessica Anne Rich, Julia Coleman, Camille Devaux, Karen Hoffman
We report a 23-year-old woman admitted post cyclist versus heavy goods vehicle accident in December 2014. This was the second case the life-saving procedure, that is, resuscitative endovascular balloon occlusion of the aorta (REBOA) was performed on at the roadside. This advanced procedure was performed due to the extensive haemorrhage from this patient's complex pelvic fracture . As a result of REBOA, the patient consequently lost her left lower limb and underwent a variety of complex pelvic and lower limb surgeries...
July 17, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28715105/a-simulation-based-approach-to-measuring-team-situational-awareness-in-emergency-medicine-a-multicenter-observational-study
#20
Elizabeth D Rosenman, Aurora J Dixon, Jessica M Webb, Sarah Brolliar, Simon J Golden, Kerin A Jones, Sachita Shah, James A Grand, Steve W J Kozlowski, Georgia T Chao, Rosemarie Fernandez
OBJECTIVES: Team situational awareness (TSA) is critical for effective teamwork and supports dynamic decision-making in unpredictable, time-pressured situations. Simulation provides a platform for developing and assessing TSA; but these efforts are limited by suboptimal measurement approaches. The objective of this study was to develop and evaluate a novel approach to TSA measurement in interprofessional emergency medicine teams. METHODS: We performed a multicenter, prospective, simulation-based observational study to evaluate an approach to TSA measurement...
July 17, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
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