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Target temperature management

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https://www.readbyqxmd.com/read/28211002/factors-that-influence-effective-perioperative-temperature-management-by-anesthesiologists-a-qualitative-study-using-the-theoretical-domains-framework
#1
Sylvain Boet, Andrea M Patey, Justine S Baron, Karim Mohamed, Ashlee-Ann E Pigford, Gregory L Bryson, Jamie C Brehaut, Jeremy M Grimshaw
PURPOSE: Inadvertent perioperative hypothermia (IPH) is associated with a range of adverse outcomes. Safe and effective warming techniques exist to prevent IPH; however, IPH remains common. This study aimed to identify factors that anesthesiologists perceive may influence temperature management during the perioperative period. METHODS: After Research Ethics Board approval, semi-structured interviews were conducted with staff anesthesiologists at a Canadian academic hospital...
February 16, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28198810/reference-genes-for-quantitative-real-time-pcr-analysis-in-symbiont-entomomyces-delphacidicola-of-nilaparvata-lugens-st%C3%A3-l
#2
Pin-Jun Wan, Yao-Hua Tang, San-Yue Yuan, Jia-Chun He, Wei-Xia Wang, Feng-Xiang Lai, Qiang Fu
Nilaparvata lugens (Stål) (Hemiptera: Delphacidae) is a major rice pest that harbors an endosymbiont ascomycete fungus, Entomomyces delphacidicola str. NLU (also known as yeast-like symbiont, YLS). Driving by demand of novel population management tactics (e.g. RNAi), the importance of YLS has been studied and revealed, which greatly boosts the interest of molecular level studies related to YLS. The current study focuses on reference genes for RT-qPCR studies related to YLS. Eight previously unreported YLS genes were cloned, and their expressions were evaluated for N...
February 13, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28194629/-68-ga-nota-galactosyl-human-serum-albumin-a-tracer-for-liver-function-imaging-with-improved-stability
#3
Roland Haubner, Andreas M Schmid, Andreas Maurer, Christine Rangger, Llanos Geraldo Roig, Bernd J Pichler, Irene J Virgolini
PURPOSE: Non-invasive techniques allowing quantitative determination of the functional liver mass are of great interest for patient management in a variety of clinical settings. Recently, we presented [(68)Ga]DTPA-GSA to target the hepatic asialoglycoprotein receptor for this purpose. Here, we introduce [(68)Ga]NOTA-GSA to improve metabolic stability of the radiopharmaceutical and compare the imaging properties with [(68)Ga]DTPA-GSA. PROCEDURES: Labeling of the compounds was carried out at room temperature using 1...
February 13, 2017: Molecular Imaging and Biology: MIB: the Official Publication of the Academy of Molecular Imaging
https://www.readbyqxmd.com/read/28191450/remotely-triggered-nano-theranostics-for-cancer-applications
#4
Alexandra Sneider, Derek VanDyke, Shailee Paliwal, Prakash Rai
Nanotechnology has enabled the development of smart theranostic platforms that can concurrently diagnose disease, start primary treatment, monitor response, and, if required, initiate secondary treatments. Recent in vivo experiments demonstrate the promise of using theranostics in the clinic. In this paper, we review the use of remotely triggered theranostic nanoparticles for cancer applications, focusing heavily on advances in the past five years. Remote triggering mechanisms covered include photodynamic, photothermal, phototriggered chemotherapeutic release, ultrasound, electro-thermal, magneto-thermal, X-ray, and radiofrequency therapies...
2017: Nanotheranostics (Syd)
https://www.readbyqxmd.com/read/28190438/therapeutic-hypothermia-protocols
#5
N Badjatia
The application of targeted temperature management has become common practice in the neurocritical care setting. It is important to recognize the pathophysiologic mechanisms by which temperature control impacts acute neurologic injury, as well as the clinical limitations to its application. Nonetheless, when utilizing temperature modulation, an organized approach is required in order to avoid complications and minimize side-effects. The most common clinically relevant complications are related to the impact of cooling on hemodynamics and electrolytes...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28184227/using-ceres-maize-and-enso-as-decision-support-tools-to-evaluate-climate-sensitive-farm-management-practices-for-maize-production-in-the-northern-regions-of-ghana
#6
Dilys S MacCarthy, Samuel G K Adiku, Bright S Freduah, Francis Gbefo, Alpha Y Kamara
Maize (Zea mays) has traditionally been a major cereal staple in southern Ghana. Through breeding and other crop improvement efforts, the zone of cultivation of maize has now extended to the northern regions of Ghana which, hitherto, were the home to sorghum and millet as the major cereals. Maize yield in the northern Ghana is hampered by three major biophysical constraints, namely, poor soil fertility, low soil water storage capacity and climate variability. In this study we used the DSSAT crop model to assess integrated water and soil management strategies that combined the pre-season El-Niño-Southern Oscillation (ENSO)-based weather forecasting in selecting optimal planting time, at four locations in the northern regions of Ghana...
2017: Frontiers in Plant Science
https://www.readbyqxmd.com/read/28173749/testing-a-systematic-approach-to-identify-and-prioritise-barriers-to-successful-implementation-of-a-complex-healthcare-intervention
#7
Louise E Craig, Leonid Churilov, Liudmyla Olenko, Dominique A Cadilhac, Rohan Grimley, Simeon Dale, Cintia Martinez-Garduno, Elizabeth McInnes, Julie Considine, Jeremy M Grimshaw, Sandy Middleton
BACKGROUND: Multiple barriers may inhibit the adoption of clinical interventions and impede successful implementation. Use of standardised methods to prioritise barriers to target when selecting implementation interventions is an understudied area of implementation research. The aim of this study was to describe a method to identify and prioritise barriers to the implementation of clinical practice elements which were used to inform the development of the T(3) trial implementation intervention (Triage, Treatment [thrombolysis administration; monitoring and management of temperature, blood glucose levels, and swallowing difficulties] and Transfer of stroke patients from Emergency Departments [ED])...
February 7, 2017: BMC Medical Research Methodology
https://www.readbyqxmd.com/read/28169132/electroencephalographic-characteristics-of-status-epilepticus-after-cardiac-arrest
#8
Sofia Backman, Erik Westhall, Irina Dragancea, Hans Friberg, Malin Rundgren, Susann Ullén, Tobias Cronberg
OBJECTIVE: To describe the electrophysiological characteristics and pathophysiological significance of electrographic status epilepticus (ESE) after cardiac arrest and specifically compare patients with unequivocal ESE to patients with rhythmic or periodic borderline patterns defined as possible ESE. METHODS: Retrospective cohort study of consecutive patients treated with targeted temperature management and monitored with simplified continuous EEG. Patients with ESE were identified and electrographically characterised until 72h after ESE start using the standardised terminology of the American Clinical Neurophysiology Society...
January 21, 2017: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://www.readbyqxmd.com/read/28168412/neuroprognostication-after-adult-cardiac-arrest-treated-with-targeted-temperature-management-task-force-for-belgian-recommendations
#9
Fabio Silvio Taccone, Ingrid Baar, Cathy De Deyne, Patrick Druwe, Benjamin Legros, Geert Meyfroidt, Michel Ossemann, Nicolas Gaspard
The prognosis of patients who are admitted to the hospital after cardiac arrest often relies on neurological examination, which could be significantly influenced by the use of sedative drugs or the implementation of targeted temperature management. The need for early and accurate prognostication is crucial as up to 15-20% of patients could be considered as having a poor outcome and may undergo withdrawal of life-sustaining therapies while a complete neurological recovery is still possible. As current practice in Belgium is still based on a very early assessment of neurological function in these patients, the Belgian Society of Intensive Care Medicine created a multidisciplinary Task Force to provide an optimal approach for monitoring and refine prognosis of CA survivors...
February 6, 2017: Acta Neurologica Belgica
https://www.readbyqxmd.com/read/28164157/interactions-between-demography-and-environmental-effects-are-important-determinants-of-population-dynamics
#10
Marlène Gamelon, Vidar Grøtan, Anna L K Nilsson, Steinar Engen, James W Hurrell, Kurt Jerstad, Adam S Phillips, Ole W Røstad, Tore Slagsvold, Bjørn Walseng, Nils C Stenseth, Bernt-Erik Sæther
Climate change will affect the population dynamics of many species, yet the consequences for the long-term persistence of populations are poorly understood. A major reason for this is that density-dependent feedback effects caused by fluctuations in population size are considered independent of stochastic variation in the environment. We show that an interplay between winter temperature and population density can influence the persistence of a small passerine population under global warming. Although warmer winters favor an increased mean population size, density-dependent feedback can cause the local population to be less buffered against occasional poor environmental conditions (cold winters)...
February 2017: Science Advances
https://www.readbyqxmd.com/read/28163232/prognostic-significance-of-clinical-seizures-after-cardiac-arrest-and-target-temperature-management
#11
Anna Lybeck, Hans Friberg, Anders Aneman, Christian Hassager, Janneke Horn, Jesper Kjærgaard, Michael Kuiper, Niklas Nielsen, Susann Ullén, Matthew P Wise, Erik Westhall, Tobias Cronberg
AIM: Clinical seizures are common after cardiac arrest and predictive of a poor neurological outcome. Seizures may be myoclonic, tonic-clonic or a combination of seizure types. This study reports the incidence and prognostic significance of clinical seizures in the target temperature management (TTM) after cardiac arrest trial. Our hypotheses were that seizures are associated with a poor prognosis and that the incidence of seizures is not affected by the target temperature. METHODS: Post-hoc analysis of reported clinical seizures during day 1-7 in the TTM-trial including their treatment, EEG-findings, and long-term neurological outcome...
February 3, 2017: Resuscitation
https://www.readbyqxmd.com/read/28159575/changing-target-temperature-from-33%C3%A2-c-to-36%C3%A2-c-in-the-icu-management-of-out-of-hospital-cardiac-arrest-a-before-and-after-study
#12
Janet E Bray, Dion Stub, Jason E Bloom, Louise Segan, Biswadev Mitra, Karen Smith, Judith Finn, Stephen Bernard
INTRODUCTION: In December 2013, our institution changed the target temperature management (TTM) for the first 24h in ventricular fibrillation out-of-hospital cardiac arrest (VF-OHCA) patients from 33°C to 36°C. This study aimed to examine the impact this change had on measured temperatures and patient outcomes. METHODS: We conducted a retrospective cohort study of consecutive VF-OHCA patients admitted to a tertiary referral hospital in Melbourne (Australia) between January 2013 and August 2015...
January 31, 2017: Resuscitation
https://www.readbyqxmd.com/read/28159373/temperature-variability-during-targeted-temperature-management-is-not-associated-with-neurological-outcomes-following-cardiac-arrest
#13
Arash Nayeri, Nirmanmoh Bhatia, Benjamin Holmes, Nyal Borges, William Armstrong, Meng Xu, Eric Farber-Eger, Quinn S Wells, John A McPherson
INTRODUCTION: Recent studies on comatose survivors of cardiac arrest undergoing targeted temperature management (TTM) have shown similar outcomes at multiple target temperatures. However, details regarding core temperature variability during TTM and its prognostic implications remain largely unknown. We sought to assess the association between core temperature variability and neurological outcomes in patients undergoing TTM following cardiac arrest. METHODS: We analyzed a prospectively collected cohort of 242 patients treated with TTM following cardiac arrest at a tertiary care hospital between 2007 and 2014...
January 27, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28155073/nimodipine-ophthalmic-formulations-for-management-of-glaucoma
#14
Doaa Nabih Maria, Abd-Elgawad Helmy Abd-Elgawad, Osama Abd-Elazeem Soliman, Marwa Salah El-Dahan, Monica M Jablonski
PURPOSE: Preparation and evaluation of topical ophthalmic formulations containing nimodipine-CD complexes prepared using HP-β-CD, SBE-β-CD and M-β-CD for the management of glaucoma. METHODS: Nimodipine-CD complexes were prepared using a freeze-drying method. Two different molar ratios (NMD:CD) were used for each cyclodextrin. The inclusion complexes were characterized using DSC, FTIR, yield (%), drug content and in vitro release characteristics. NMD-CD complexes incorporated into chitosan eye drops and a temperature-triggered in situ gelling system were evaluated for their pH, viscosity and in vitro release characteristics...
February 2, 2017: Pharmaceutical Research
https://www.readbyqxmd.com/read/28150290/a-review-of-the-utility-of-a-hypothermia-protocol-in-cardiac-arrests-due-to-non-shockable-rhythms
#15
Brin Freund, Peter W Kaplan
BACKGROUND: Therapeutic hypothermia and targeted temperature management are considered standard of care in the management of patients following out-of-hospital cardiac arrests due to shockable rhythms to improve neurological outcomes. In those presenting out-of-hospital cardiac arrests associated with non-shockable rhythms, the benefit of hypothermia is less clear. In this review we try to clarify the utility of implementing a hypothermia protocol after cardiac arrests due to non-shockable rhythms...
February 2, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/28147417/neurologic-prognostication-neurologic-examination-and-current-guidelines
#16
Claudio Sandroni, Sonia D'Arrigo
Clinical examination is paramount for prognostication in patients who are comatose after resuscitation from cardiac arrest. At 72 hours from recovery of spontaneous circulation (ROSC), an absent or extensor motor response to pain (M ≤ 2) is a very sensitive, but not specific predictor of poor neurologic outcome. Bilaterally absent pupillary or corneal reflexes are less sensitive, but highly specific predictors. Besides the clinical examination, investigations such as somatosensory evoked potentials (SSEPs), electroencephalography (EEG), blood levels of neuron-specific enolase (NSE), or imaging studies can be used for neuroprognostication...
February 2017: Seminars in Neurology
https://www.readbyqxmd.com/read/28147416/treatment-of-seizures-and-postanoxic-status-epilepticus
#17
Alexandra S Reynolds, Jan Claassen
Seizures are a common occurrence following cardiac arrest and may occur both during targeted temperature management and after rewarming. Postanoxic seizures may be nonconvulsive and very difficult to diagnose without electroencephalography (EEG) or associated with prominent myoclonus. Importantly, to date no randomized controlled trials are available to guide the management of seizures in patients with cardiac arrest. Seizure prophylaxis is not recommended, and when seizures are diagnosed they are typically treated the same as seizures in other patients with acute brain injury...
February 2017: Seminars in Neurology
https://www.readbyqxmd.com/read/28147415/improving-survival-after-cardiac-arrest
#18
Conrad Arnfinn Bjørshol, Eldar Søreide
Each year, approximately half a million people suffer out-of-hospital cardiac arrest (CA) in Europe: The majority die. Survival after CA varies greatly between regions and countries. The authors give an overview of the important elements necessary to promote improved survival after CA as a function of the chain of survival and formula for survival concepts. The chain of survival incorporates bystanders (who identify warning symptoms, call the emergency dispatch center, initiate cardiopulmonary resuscitation [CPR]), dispatchers (who identify CA, and instruct and reassure the caller), first responders (who provide high-quality CPR, early defibrillation), paramedics and other prehospital care providers (who continue high-quality CPR, and provide timely defibrillation and advanced life support, transport to CA center), and hospitals (targeted temperature management, percutaneous coronary intervention, delayed prognostication)...
February 2017: Seminars in Neurology
https://www.readbyqxmd.com/read/28122159/hypothermia-and-targeted-temperature-management-in-cats-and-dogs
#19
Andrea Brodeur, Annie Wright, Yonaira Cortes
OBJECTIVE: To review current knowledge surrounding the effects, treatment, and prognosis of hypothermia in people, dogs, and cats, as well as the application of therapeutic hypothermia in clinical medicine. ETIOLOGY: Hypothermia may be a primary or secondary condition, and may be due to environmental exposure, illness, medications, anesthesia, or trauma. Hypothermia has been applied therapeutically in human medicine for a variety of conditions, including postcardiac arrest...
January 25, 2017: Journal of Veterinary Emergency and Critical Care
https://www.readbyqxmd.com/read/28118559/therapeutic-hypothermia-after-in-hospital-cardiac-arrest-in-children
#20
RANDOMIZED CONTROLLED TRIAL
Frank W Moler, Faye S Silverstein, Richard Holubkov, Beth S Slomine, James R Christensen, Vinay M Nadkarni, Kathleen L Meert, Brittan Browning, Victoria L Pemberton, Kent Page, Marianne R Gildea, Barnaby R Scholefield, Seetha Shankaran, Jamie S Hutchison, John T Berger, George Ofori-Amanfo, Christopher J L Newth, Alexis Topjian, Kimberly S Bennett, Joshua D Koch, Nga Pham, Nikhil K Chanani, Jose A Pineda, Rick Harrison, Heidi J Dalton, Jeffrey Alten, Charles L Schleien, Denise M Goodman, Jerry J Zimmerman, Utpal S Bhalala, Adam J Schwarz, Melissa B Porter, Samir Shah, Ericka L Fink, Patrick McQuillen, Theodore Wu, Sophie Skellett, Neal J Thomas, Jeffrey E Nowak, Paul B Baines, John Pappachan, Mudit Mathur, Eric Lloyd, Elise W van der Jagt, Emily L Dobyns, Michael T Meyer, Ronald C Sanders, Amy E Clark, J Michael Dean
Background Targeted temperature management is recommended for comatose adults and children after out-of-hospital cardiac arrest; however, data on temperature management after in-hospital cardiac arrest are limited. Methods In a trial conducted at 37 children's hospitals, we compared two temperature interventions in children who had had in-hospital cardiac arrest. Within 6 hours after the return of circulation, comatose children older than 48 hours and younger than 18 years of age were randomly assigned to therapeutic hypothermia (target temperature, 33...
26, 2017: New England Journal of Medicine
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