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Fluid managment

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https://www.readbyqxmd.com/read/28719483/difficult-intubation-and-ventilation-in-an-infant-with-retropharyngeal-abscess-with-mediastinal-extension
#1
Michael A Bruno, Tomas Drabek, Mioara D Manole
A previously healthy 7-month-old male infant presented for evaluation of fever, deceased oral intake, and intermittent noisy breathing. Physical examination revealed neck tenderness. Soft tissue neck radiographs and computed tomography (CT) scan supported a diagnosis of retropharyngeal swelling with extension to the superior mediastinum. Surgical exploration was planned, and endotracheal intubation was performed in the operating room. Significant cardiorespiratory derangements developed immediately after the tracheal tube was inserted, including hypotension, hypoxia, and bradycardia with signs of cardiac ischemia...
July 17, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28719432/perioperative-fluid-management
#2
Brenton Alexander, Alexandre Joosten
No abstract text is available yet for this article.
July 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28719397/obesity-and-pancreatitis
#3
Biswajit Khatua, Bara El-Kurdi, Vijay P Singh
PURPOSE OF REVIEW: The obesity pandemic poses a unique set of problems for acute pancreatitis - both by increasing acute pancreatitis incidence, and worsening acute pancreatitis severity. This review explores these associations, underlying mechanisms, and potential therapies. RECENT FINDINGS: We review how the obesity associated increase in gallstones, surgical, and endoscopic interventions for obesity management, diabetes, and related medications such as incretin-based therapies and hypertriglyceridemia may increase the incidence of acute pancreatitis...
July 17, 2017: Current Opinion in Gastroenterology
https://www.readbyqxmd.com/read/28717579/deep-learning-based-automated-segmentation-of-macular-edema-in-optical-coherence-tomography
#4
Cecilia S Lee, Ariel J Tyring, Nicolaas P Deruyter, Yue Wu, Ariel Rokem, Aaron Y Lee
Evaluation of clinical images is essential for diagnosis in many specialties. Therefore the development of computer vision algorithms to help analyze biomedical images will be important. In ophthalmology, optical coherence tomography (OCT) is critical for managing retinal conditions. We developed a convolutional neural network (CNN) that detects intraretinal fluid (IRF) on OCT in a manner indistinguishable from clinicians. Using 1,289 OCT images, the CNN segmented images with a 0.911 cross-validated Dice coefficient, compared with segmentations by experts...
July 1, 2017: Biomedical Optics Express
https://www.readbyqxmd.com/read/28716645/update-in-management-of-severe-hypoxemic-respiratory-failure
#5
REVIEW
Dharani Kumari Narendra, Dean R Hess, Curtis N Sessler, Habtamu M Belete, Kalpalatha K Guntupalli, Felix Khusid, Charles Mark Carpati, Mark Elton Astiz, Suhail Raoof
Mortality related to severe-moderate and severe ARDS remains high. We searched the literature to update this topic. We defined severe hypoxemic respiratory failure as PaO2/FIO2 < 150 mm Hg (i.e., severe-moderate and severe ARDS). For these patients, we support setting the ventilator to a tidal volume of 4-8 mL/kg predicted body weight (PBW) with plateau pressure ≤30 cm H2O, and initial PEEP of 10 - 12 cm H2O. To promote alveolar recruitment, we propose increasing PEEP in increments of 2 - 3 cm, provided plateau pressure remains ≤30 cm H2O and driving pressure does not increase...
July 14, 2017: Chest
https://www.readbyqxmd.com/read/28716254/a-predictive-score-followed-by-nucleic-acid-amplification-for-adult-tuberculous-meningitis-diagnosis-in-southern-brazil
#6
Lívia Maria Pala Anselmo, Cinara Feliciano, Fernando Mauad, Margarida Passeri do Nascimento, Renata Candido Pocente, Jorgete Maria Silva, Valdes Roberto Bollela
From 2012 to 2013, 300 adults under investigation of tuberculous meningitis (TBM) were tested with polymerase chain reaction (PCR) in central spinal fluid (CSF), followed by TBM score calculation. There were 33(11%) confirmed TBM cases based on clinical findings, CSF-culture; biopsy/necropsy exams and clinical improvement after tuberculosis specific treatment. Other 267 adults were classified as non-TBM. Based on the original score there were 143 possible cases (6≤score≤11) and 20(60.6%) out of 33 TBM; among 27 probable TBM (score≥12) there were 13/33 (39...
August 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28714258/renal-neuroendocrine-control-of-desiccation-and-cold-tolerance-by-drosophila-suzukii
#7
Selim Terhzaz, Lucy Alford, Joseph G C Yeoh, Richard Marley, Anthony J Dornan, Julian A T Dow, Shireen A Davies
BACKGROUND: Neuropeptides are central to the regulation of physiological, and behavioural processes in insects, directly impacting cold and desiccation survival. However, little is known about the control mechanisms governing these responses in D. suzukii. The close phylogenetic relationship of D. suzukii with D. melanogaster allows, through genomic and functional studies, an insight into the mechanisms directing stress tolerance in D. suzukii. RESULTS: Capa, Leucokinin, DH44 and DH31 neuropeptides demonstrate a high level of conservation between D...
July 17, 2017: Pest Management Science
https://www.readbyqxmd.com/read/28712543/influence-of-overlapping-pattern-of-multiple-overlapping-uncovered-stents-on-the-local-mechanical-environment-a-patient-specific-parameter-study
#8
Shuo Wang, Yongxue Zhang, Jiaxuan Feng, Yuan Huang, Aziz Tokgoz, Umar Sadat, Jonathan H Gillard, Qingsheng Lu, Zhongzhao Teng
BACKGROUND: Multiple overlapping uncovered stents (MOUS) system has shown potentials in managing complex aortic aneurysms with side branches involvement. It promotes the development of thrombus by modulating local flow pattern that reduces the wall tension, while maintaining patency of side branches. However the modulation of local hemodynamic parameters depends on various factors that have not been assessed comprehensively. METHODS: Aneurysm 3D geometry was reconstructed based on CT images...
July 5, 2017: Journal of Biomechanics
https://www.readbyqxmd.com/read/28712199/multimodality-imaging-approach-for-the-early-diagnosis-boerhaave-syndrome
#9
Javed Anwar, Rasikh Maqsood, Sanaullah Soomro
Boerhaave's syndrome is a spontaneous transmural rupture or perforation of the oesophagus or post-emesis oesophageal rupture. Boerhaave's syndrome has a high risk of morbidity and mortality, and early, definitive diagnosis leading to prompt management improves outcomes. Definitive diagnosis of this syndrome is made with imaging, including x-ray, USG and computed tomography Scan. This is a case of a 50-year male with history of sudden onset of epigastric pain after an episode of forceful emesis was referred for Ultrasound (USG) abdomen...
January 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28711543/clival-defect-with-primary-csf-rhinorrhea-a-very-rare-presentation-with-challenging-management
#10
Sheikh Asad, Jens Peters-Willke, Warwick Brennan, Saima Asad
Primary spontaneous cerebrospinal fluid (CSF) rhinorrhea due to clival defect is an extremely rare presentation and only six cases have been reported in the literature so far(17). We present a unique case of a 64-year-old lady who presented with 2 years history of ongoing CSF rhinorrhea. She had similar episode at the age of 40 and suffered from meningitis. She had MRI, CT cisternogram as well as CT of brain and that showed clival defect with CSF leak into the sphenoid sinus. She underwent trans-sphenoidal repair of the clival defect with concurrent lumbar drain insertion for CSF drainage...
July 12, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28710882/mid-trimester-preterm-premature-rupture-of-membranes-pprom-etiology-diagnosis-classification-international-recommendations-of-treatment-options-and-outcome
#11
REVIEW
Michael Tchirikov, Natalia Schlabritz-Loutsevitch, James Maher, Jörg Buchmann, Yuri Naberezhnev, Andreas S Winarno, Gregor Seliger
Mid-trimester preterm premature rupture of membranes (PPROM), defined as rupture of fetal membranes prior to 28 weeks of gestation, complicates approximately 0.4%-0.7% of all pregnancies. This condition is associated with a very high neonatal mortality rate as well as an increased risk of long- and short-term severe neonatal morbidity. The causes of the mid-trimester PPROM are multifactorial. Altered membrane morphology including marked swelling and disruption of the collagen network which is seen with PPROM can be triggered by bacterial products or/and pro-inflammatory cytokines...
July 15, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28710563/an-observational-study-examining-the-effects-of-a-surgically-induced-inflammatory-response-on-the-distribution-of-morphine-and-its-metabolites-into-cerebrospinal-fluid
#12
Yan Wang, Kerry B Goralski, Derek J Roberts, Kathryn Landry, Mark E Issa, Lekha Sleno, Lisa C Julien, Jeremy Wood, Richard I Hall
PURPOSE: Morphine is administered intravenously for pain management in the perioperative period. The effect of the inflammatory response to surgery on morphine distribution across the blood-brain barrier (BBB) in humans was investigated. We hypothesized that a graded surgically induced, systemic inflammatory response alters cerebrospinal fluid (CSF) levels of morphine, morphine-3-glucuronide (M3G), and morphine-6-glucuronide (M6G) through a temporary reduction in BBB drug efflux transporter function...
July 14, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28709949/pulmonary-hypoplasia
#13
REVIEW
C Michael Cotten
To survive the transition to extrauterine life, newborn infants must have lungs that provide an adequate surface area and volume to allow for gas exchange. The dynamic activities of fetal breathing movements and accumulation of lung luminal fluid are key to fetal lung development throughout the various phases of lung development and growth, first by branching morphogenesis, and later by septation. Because effective gas exchange is essential to survival, pulmonary hypoplasia is among the leading findings on autopsies of children dying in the newborn period...
July 11, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28708472/rectal-instillation-of-cold-fluids-for-targeted-temperature-management-after-cardiac-arrest-a-case-report
#14
Andrej Markota, Jure Fluher, Andreja Sinkovič
The optimal method of temperature management after cardiac arrest remains unknown. Methods that are most effective are usually invasive and expensive. Noninvasive methods are not as effective and obstruct access to the patient. Temperature management via rectal cooling offers some potential advantages in survivors of cardiac arrest, namely, relatively large volumes of temperature-controlled fluids can be instilled, access to the patient is not obstructed, and fluid overload can be ameliorated by removal of a fraction of instilled fluid...
July 14, 2017: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/28708421/relationship-between-race-and-the-effect-of-fluids-on-long-term-mortality-after-acute-respiratory-distress-syndrome-secondary-analysis-of-the-nhlbi-fluid-and-catheter-treatment-trial
#15
Sarah E Jolley, Catherine L Hough, Gilles Clermont, Douglas Hayden, Suqin Hou, David Schoenfeld, Nicholas L Smith, Boyd Taylor Thompson, Gordon R Bernard, Derek C Angus
RATIONALE: Short-term follow up in the Fluid and Catheter Treatment Trial (FACTT) suggested differential mortality by race with conservative fluid management, but no significant interaction. OBJECTIVE: In a post-hoc analysis of FACTT including one-year follow up, we sought to estimate long-term mortality by race and test for an interaction between fluids and race. METHODS: Post-hoc analysis of FACTT and the Economic Analysis of Pulmonary Artery Catheters (EAPAC) study (included 655 of the 1000 FACTT patients with near complete one-year follow up)...
July 14, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28708033/neuropsychological-profile-and-social-cognition-in-congenital-central-hypoventilation-syndrome-cchs-correlation-with-neuroimaging-in-a-clinical-case
#16
Borja Esteso Orduña, Raquel Seijas Gómez, Elena García Esparza, Emily M Briceño, Javier Melero Llorente, María de la Concepción Fournier Del Castillo
INTRODUCTION: Congenital central hypoventilation syndrome (CCHS) is a rare genetic disorder due to paired-like homeobox gene (PHOX2B) mutations. CCHS patients suffer from dysregulation of the autonomic nervous system characterized by the absence of or extremely reduced response to hypercapnia and hypoxia, with neuropsychological deficits. The aim of this exploratory study is to describe the longitudinal neuropsychological profile and its correlations with magnetic resonance imaging (MRI) of a child with CCHS with a PHOX2B mutation...
July 14, 2017: Journal of Clinical and Experimental Neuropsychology
https://www.readbyqxmd.com/read/28705799/rapid-developing-empyema-by-group-f-beta-streptococcus-anginosus-group
#17
Muhammad Azharuddin, Dy Prudence, Prem Shanker Shukla, Ajay Mathur
A 43-year-old male had progressive pleuritic left-sided chest tightness with shortness of breath. He had dental caries and tenderness on palpation of the left lateral chest. Complete blood count showed leucocytosis. CT scan of the chest with pulmonary emboli protocol showed multiple pulmonary nodules and nodular pleural thickening at left posterior lateral pleura. Forty-eight hours post CTPE scan, CT scan of the chest, abdomen and pelvis displayed right lower lobe consolidation and left-sided pleural effusion with superimposed compressive atelectasis...
July 13, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28704823/different-behavior-and-response-of-staphylococcus-epidermidis-and-streptococcus-pneumoniae-to-a-ventriculoperitoneal-shunt-an-in-vitro-study
#18
Vahid Heidari, Zohreh Habibi, Ahmadreza Hojjati Marvasti, Zahra Ebrahim Soltani, Negin Naderian, Parvin Tanzifi, Farideh Nejat
BACKGROUND: Pneumococcal shunt infection is a rare event. There is no consensus on the therapeutic management of this kind of shunt infection according to literature reviews, and it seems to be different from infection with Staphylococcus epidermidis. We studied 2 shunted patients with pneumococcal meningitis, both of whom were treated with only antibiotics. The management of these cases seems to be different from that of shunt catheter infection due to these bacteria. We conducted a laboratory study to show the different behavior of pneumococcus compared to S...
July 14, 2017: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28704811/the-evolution-of-cerebrospinal-fluid-shunts-advances-in-technology-and-technique
#19
Krystal L Tomei
Over the past few centuries, there have been many advances in shunt technology, from the evolution of shunt tubing materials, to advances in valves for regulating the flow of cerebrospinal fluid (CSF). Additional medical advances have enabled the antibiotic impregnation of catheters. Finally, advances in technology have expanded the options for minimally invasive techniques and improved the management of complicated cases of hydrocephalus. The evolution of technology and technique in the management of hydrocephalus with CSF shunts will be discussed here...
July 14, 2017: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28704038/eosinophilic-meningitis-caused-by-angiostrongylus-cantonensis
#20
Shan Lv, Xiao-Nong Zhou, Jason R Andrews
Rat lungworm, Angiostrongylus cantonensis, is one major cause of human eosinophilic meningitis. This helminth is endemic in Southeast Asia, Pacific Islands, and the Caribbean and has recently expanded to South America. The infection is characterized by an elevated eosinophil count in cerebrospinal fluid. Common symptoms and signs include headache, neck stiffness, paresthesia and nausea/vomiting. The unique history of eating freshwater and land snails or slugs within 2 weeks before onset is helpful for diagnosis...
July 13, 2017: ACS Chemical Neuroscience
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