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Fluid managment

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https://www.readbyqxmd.com/read/28329191/management-of-ventriculoperitoneal-shunt-infections-in-adults-analysis-of-risk-factors-associated-with-treatment-failure
#1
Iván Pelegrín, Jaime Lora-Tamayo, Joan Gómez-Junyent, Nuria Sabé, Dolors García-Somoza, Andreu Gabarrós, Javier Ariza, Pedro Fernández Viladrich, Carmen Cabellos
Background.: Little is known regarding the optimal treatment of ventriculoperitoneal (VP) shunt infections in adults. Our aim was to assess the efficacy of treatment strategies and to identify factors that predict failure. Methods.: Retrospective, observational study of patients aged ≥12 years with VP shunt infections (1980 -2014). Therapeutic approaches were classified under 4 headings: only antibiotics (OA), one-stage shunt replacement (OSSR), two-stage shunt replacement (TSSR), and shunt removal without replacement (SR)...
March 10, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28328650/exosomes-in-critical-illness
#2
Nora Terrasini, Vincenzo Lionetti
OBJECTIVE: Exosomes are small, cell-released vesicles (40-100 nm in size) with the potential to transfer proteins, lipids, small RNAs, messenger RNAs, or DNA between cells via interstitial fluids. Due to their role in tissue homeostasis, exosomes have emerged as a new type of therapeutic and diagnostic (theranostic) tool in the noninvasive assessment of organ response to injury or treatment and in the development of reliable organ-protective intensive therapy. Our review provides current insights into the role of exosomes in the personalized management of injury and repair responses in critical illness...
March 21, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28325581/prenatal-prediction-of-pulmonary-hypoplasia
#3
REVIEW
Jourdan E Triebwasser, Marjorie C Treadwell
Pulmonary hypoplasia, although rare, is associated with significant neonatal morbidity and mortality. Conditions associated with pulmonary hypoplasia include those which limit normal thoracic capacity or movement, including skeletal dysplasias and abdominal wall defects; those with mass effect, including congenital diaphragmatic hernia and pleural effusions; and those with decreased amniotic fluid, including preterm, premature rupture of membranes, and genitourinary anomalies. The ability to predict severe pulmonary hypoplasia prenatally aids in family counseling, as well as obstetric and neonatal management...
March 15, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28325460/cranioplasty
#4
REVIEW
Matthew Piazza, M Sean Grady
Cranioplasty following craniectomy for trauma is a common, safe neurosurgical procedure that restores the natural cosmesis and protective barrier of the skull and may be instrumental in normalizing cerebrospinal fluid dynamics after decompressive surgery. Understanding the factors influencing patient selection and timing of cranioplasty, the available materials and methods of skull reconstruction, and the technical nuances is critical for a successful outcome. Neurosurgeons must be prepared to manage the complications specific to this operation...
April 2017: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/28323719/passive-leg-raising-for-assessment-of-volume-responsiveness-a-review
#5
Jaume Mesquida, Guillem Gruartmoner, Ricard Ferrer
PURPOSE OF REVIEW: To evaluate the existing evidence on the passive leg raising (PLR) test for fluid responsiveness prediction. RECENT FINDINGS: It has been well established that either insufficient or excessive fluid administration derives in worse outcomes in critically ill patients, highlighting that a more accurate assessment of fluid management is required. Accordingly, several cardiovascular indices have been tested to improve our ability to predict patients' response to fluid loading at the bedside, the so-called functional hemodynamic monitoring...
March 20, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28322063/discrepancies-between-blood-glucose-and-interstitial-glucose-technological-artifacts-or-physiology
#6
Thorsten Siegmund, Lutz Heinemann, Ralf Kolassa, Andreas Thomas
BACKGROUND: For decades, the major source of information used to make therapeutic decisions by patients with diabetes has been glucose measurements using capillary blood samples. Knowledge gained from clinical studies, for example, on the impact of metabolic control on diabetes-related complications, is based on such measurements. Different to traditional blood glucose measurement systems, systems for continuous glucose monitoring (CGM) measure glucose in interstitial fluid (ISF). The assumption is that glucose levels in blood and ISF are practically the same and that the information provided can be used interchangeably...
March 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28321928/eus-evaluation-for-pancreatic-cysts-necessity-or-overkill
#7
REVIEW
Nonthalee Pausawasdi, Thawee Ratanachu-Ek
Incidental pancreatic cysts have been gradually more recognized in clinical practice due to an increased use of transabdominal ultrasound, computed tomography (CT) and magnetic resonance imaging (MRI). These lesions consist of inflammatory cysts (pseudocysts) and pancreatic cystic neoplasms (PCNs) which have been classified as benign, pre-malignant and malignant. The diagnosis and management strategy of incidentally discovered pancreatic cysts can be challenging as the majority of them are PCNs and CT or MRI alone may not be sufficient to provide an accurate diagnosis...
March 21, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28321372/treatment-outcomes-of-rathke-s-cleft-cysts-managed-with-marsupialization
#8
Edward C Kuan, Frederick Yoo, Jennifer Chyu, Marvin Bergsneider, Marilene B Wang
Objectives Rathke's cleft cysts (RCC) are benign cystic lesions of the sella resulting from incomplete obliteration of Rathke's cleft. Symptomatic lesions often require surgical decompression, which is often amenable to a transnasal, transsphenoidal (TNTS) approach. We report our experience with marsupialization of RCC and describe a novel technique to promote re-epithelization of the cyst cavity. Design Retrospective review. Setting Tertiary academic medical center. Participants Patients who underwent TNTS for RCC between 2007 and 2015...
April 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28321088/drug-induced-interstitial-pneumonitis-in-essential-thrombocythemia-treated-with-anagrelide
#9
Tomohiro Kajiguchi, Sonoko Kamoshita, Takayasu Ito, Mitsuaki Yagi, Tomoki Kimura
Anagrelide, a phospholipase A2 inhibitor, is widely used in the management of essential thrombocythemia. To date, anagrelide has only rarely been reported to be associated with the development of drug-induced interstitial pneumonitis. We herein report two cases of anagrelide-associated interstitial pneumonitis. The patients were a 67-year-old woman and a 75-year-old man, both with essential thrombocythemia. Both cases developed interstitial pneumonitis at 8 weeks after administration of anagrelide. Because anagrelide-induced interstitial pneumonitis was suspected from CT scan and bronchoalveolar lavage fluid findings, anagrelide-therapy was discontinued and corticosteroid administration was initiated...
2017: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
https://www.readbyqxmd.com/read/28320354/slow-progress-in-diarrhea-case-management-in-low-and-middle-income-countries-evidence-from-cross-sectional-national-surveys-1985-2012
#10
Chandrashekhar T Sreeramareddy, Yue-Peng Low, Birger Carl Forsberg
BACKGROUND: Diarrhea remains to be a main cause of childhood mortality. Diarrhea case management indicators reflect the effectiveness of child survival interventions. We aimed to assess time trends and country-wise changes in diarrhea case management indicators among under-5 children in low-and-middle-income countries. METHODS: We analyzed aggregate data from Demographic and Health Surveys and Multiple Indicator Cluster Surveys done from 1986 to 2012 in low-and-middle-income countries...
March 21, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28320151/takotsubo-cardiomyopathy-in-amyotrophic-lateral-sclerosis
#11
Seok-Jin Choi, Yoon-Ho Hong, Je-Young Shin, Byung-Nam Yoon, Sung-Yeon Sohn, Chan Soon Park, Jung-Joon Sung
OBJECTIVE: To investigate the frequency, features, and prognosis of takotsubo cardiomyopathy (TTC) in patients with amyotrophic lateral sclerosis (ALS). METHODS: We reviewed detailed clinical, laboratory, and cardiovascular data from 64 ALS patients (38 men and 26 women) who underwent echocardiographic evaluation for various reasons at a single referral center between January 2011 and December 2015. RESULTS: TTC was diagnosed in 9 ALS patients (4 men and 5 women)...
April 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28320145/vision-loss-in-tuberculous-meningitis
#12
REVIEW
Ravindra Kumar Garg, Hardeep Singh Malhotra, Neeraj Kumar, Ravi Uniyal
Vision loss is a disabling complication of tuberculous meningitis. Approximately, 15% of survivors are either completely or partially blind. All structures of the visual pathway may be affected in tuberculous meningitis. Optic nerve and optic chiasma are most frequently and dominantly affected. Thick-gelatinous exudates lying over the base of brain, are the pathological hallmark of tuberculous meningitis and are responsible for almost all of its major complications, including vision loss. Strangulation of optic nerves and optic chiasma by the exudates, compression over optic chiasma by the dilated third ventricle, raised intracranial pressure, endarteritis, shunt failure, bacterial invasion of optic nerves and drug-induced optic nerve damage are important reasons that are considered responsible for vision loss...
April 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28320142/ventriculo-peritoneal-shunt-surgery-for-tuberculous-meningitis-a-systematic-review
#13
Imran Rizvi, Ravindra Kumar Garg, Hardeep Singh Malhotra, Neeraj Kumar, Eesha Sharma, Chhitij Srivastava, Ravi Uniyal
BACKGROUND: Ventriculo-peritoneal shunt surgery is one of the most commonly performed surgery for the management of tuberculous hydrocephalus. There is decreased clarity on issues regarding the indication as well as timing of cerebrospinal fluid diversion procedures in tuberculous meningitis. We systematically analysed published literature on this subject with an objective to assess the value of cerebrospinal fluid diversion procedures in tuberculous meningitis. METHODS: A systematic search of literature was performed using PubMed, Scopus, and Cochrane Central Register of Controlled Trials (CENTRAL) for articles published till August 2016...
April 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28320134/post-hemorrhagic-hydrocephalus-recent-advances-and-new-therapeutic-insights
#14
REVIEW
Qianwei Chen, Zhou Feng, Qiang Tan, Jing Guo, Jun Tang, Liang Tan, Hua Feng, Zhi Chen
Post-hemorrhagic hydrocephalus (PHH), also referred to as progressive ventricular dilatation, is caused by disturbances in cerebrospinal fluid (CSF) flow or absorption following hemorrhage in the brain. As one of the most serious complications of neonatal/adult intraventricular hemorrhage (IVH), subarachnoid hemorrhage (SAH), and traumatic brain injury (TBI), PHH is associated with increased morbidity and disability of these events. Common sequelae of PHH include neurocognitive impairment, motor dysfunction, and growth impairment...
April 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28319546/gastric-fluid-volume-change-after-oral-rehydration-solution-intake-in-morbidly-obese-and-normal-controls-a-magnetic-resonance-imaging-based-analysis
#15
Toshie Shiraishi, Dai Kurosaki, Mitsuyo Nakamura, Taiji Yazaki, Satomi Kobinata, Yosuke Seki, Kazunori Kasama, Hideki Taniguchi
BACKGROUND: Although preoperative fluid intake 2 hours before anesthesia is generally considered safe, there are concerns about delayed gastric emptying in obese subjects. In this study, the gastric fluid volume (GFV) change in morbidly obese subjects was investigated after ingesting an oral rehydration solution (ORS) and then compared with that in nonobese subjects. METHODS: GFV change over time after the ingestion of 500 mL of ORS containing 2.5% carbohydrate (OS-1) was measured in 10 morbidly obese subjects (body mass index [BMI], >35) scheduled for bariatric surgery and 10 nonobese (BMI, 19-24) using magnetic resonance imaging...
April 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28318981/idiopathic-intradural-dorsal-thoracic-arachnoid-cysts-a-case-series-and-review-of-the-literature
#16
Heath French, Arjuna Somasundaram, Michael Biggs, Jonathon Parkinson, Rodney Allan, Jonathon Ball, Nicholas Little
BACKGROUND: Spinal intradural arachnoid cysts (SIAC) are cerebrospinal fluid (CSF) filled sacs formed by arachnoid membranes and may be either idiopathic or acquired. Idiopathic cysts represent a separate entity and their aetiology remains uncertain. By far the most difficult differential diagnosis is distinguishing between idiopathic anterior spinal cord herniation (IASCH) and dorsal thoracic intradural arachnoid cysts (TIAC), due to their similarity in radiological appearance. Cine-mode (SSFP) is emerging as a novel technique in the diagnosis and operative planning of SIAC...
March 17, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28318880/highly-conformal-craniospinal-radiotherapy-techniques-can-underdose-the-cranial-clinical-target-volume-if-leptomeningeal-extension-through-skull-base-exit-foramina-is-not-contoured
#17
D J Noble, T Ajithkumar, J Lambert, I Gleeson, M V Williams, S J Jefferies
AIMS: Craniospinal irradiation (CSI) remains a crucial treatment for patients with medulloblastoma. There is uncertainty about how to manage meningeal surfaces and cerebrospinal fluid (CSF) that follows cranial nerves exiting skull base foramina. The purpose of this study was to assess plan quality and dose coverage of posterior cranial fossa foramina with both photon and proton therapy. MATERIALS AND METHODS: We analysed the radiotherapy plans of seven patients treated with CSI for medulloblastoma and primitive neuro-ectodermal tumours and three with ependymoma (total n = 10)...
March 15, 2017: Clinical Oncology: a Journal of the Royal College of Radiologists
https://www.readbyqxmd.com/read/28318633/capillary-leak-syndrome-etiologies-pathophysiology-and-management
#18
REVIEW
Eric Siddall, Minesh Khatri, Jai Radhakrishnan
In various human diseases, an increase in capillary permeability to proteins leads to the loss of protein-rich fluid from the intravascular to the interstitial space. Although sepsis is the disease most commonly associated with this phenomenon, many other diseases can lead to a "sepsis-like" syndrome with manifestations of diffuse pitting edema, exudative serous cavity effusions, noncardiogenic pulmonary edema, hypotension, and, in some cases, hypovolemic shock with multiple-organ failure. The term capillary leak syndrome has been used to describe this constellation of disease manifestations associated with an increased capillary permeability to proteins...
March 16, 2017: Kidney International
https://www.readbyqxmd.com/read/28317394/an-update-on-the-pathophysiology-and-management-of-polycystic-liver-disease
#19
May Yw Wong, Geoffrey W McCaughan, Simone I Strasser
Polycystic liver disease (PLD) is characterized by the presence of multiple cholangiocyte-derived hepatic cysts that progressively replace liver tissue. They are classified as an inherited ciliopathy /cholangiopathy as pathology exists at the level of the primary cilia of cholangiocytes. Aberrant expression of the proteins in primary cilia can impair their structures and functions, thereby promoting cystogenesis. Areas covered: This review begins by looking at the epidemiology of PLD and its natural history...
March 18, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28317208/current-status-of-interventional-endoscopic-ultrasound
#20
REVIEW
Shomei Ryozawa, Naotaka Fujita, Atsushi Irisawa, Yoshiki Hirooka, Tetsuya Mine
Endoscopic ultrasound (EUS) is being used increasingly in the management of pancreatic fluid collection, biliary and pancreatic duct drainage in cases of failed endoscopic retrograde cholangiopancreatography, drainage of the gallbladder, and other conditions. The role of interventional EUS is rapidly expanding and new interventions are continuously emerging. The development of devices could be a major breakthrough in the field of interventional EUS. New devices would enable the expansion of its role even further and prompt its widespread use in clinical practice...
March 20, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
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