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https://www.readbyqxmd.com/read/29673370/early-versus-standard-initiation-of-renal-replacement-therapy-in-furosemide-stress-test-non-responsive-acute-kidney-injury-patients-the-fst-trial
#1
Nuttha Lumlertgul, Sadudee Peerapornratana, Thananda Trakarnvanich, Wanjak Pongsittisak, Kajbundit Surasit, Anan Chuasuwan, Pleumjit Tankee, Khajohn Tiranathanagul, Kearkiat Praditpornsilpa, Kriang Tungsanga, Somchai Eiam-Ong, John A Kellum, Nattachai Srisawat
BACKGROUND: The timing of initiation of renal replacement therapy (RRT) in severe acute kidney injury (AKI) remains controversial, with early initiation resulting in unnecessary therapy for some patients while expectant therapy may delay RRT for other patients. The furosemide stress test (FST) has been shown to predict the need for RRT and therefore could be used to exclude low-risk patients from enrollment in trials of RRT timing. We conducted this multicenter pilot study to determine whether FST could be used to screen patients at high risk for RRT and to determine the feasibility of incorporating FST into a trial of early initiation of RRT...
April 19, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29664109/forced-fluid-removal-in-intensive-care-patients-with-acute-kidney-injury-the-randomised-ffaki-feasibility-trial
#2
R E Berthelsen, A Perner, A K Jensen, B S Rasmussen, J U Jensen, J Wiis, M T Behzadi, M H Bestle
BACKGROUND: Accumulation of fluids is frequent in intensive care unit (ICU) patients with acute kidney injury and may be associated with increased mortality and decreased renal recovery. We present the results of a pilot trial assessing the feasibility of forced fluid removal in ICU patients with acute kidney injury and fluid accumulation of more than 10% ideal bodyweight. METHODS: The FFAKI-trial was a pilot trial of forced fluid removal vs standard care in adult ICU patients with moderate to high risk acute kidney injury and 10% fluid accumulation...
April 17, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29657727/preoperative-fluid-restriction-for-trauma-patients-with-hemorrhagic-shock-decreases-ventilator-days
#3
Shigenari Matsuyama, Ryusuke Miki, Hirotada Kittaka, Haruki Nakayama, Shota Kikuta, Satoshi Ishihara, Shinichi Nakayama
Aim: In recent years, with the concept of damage control resuscitation, hemostasis and preoperative fluid restriction have been carried out, but there is controversy regarding the effectiveness of fluid restriction. Methods: From April 2007 to March 2013, 101 trauma patients presented with hemorrhagic shock (systolic blood pressure ≤90 mmHg) at the prehospital or emergency department and were admitted to Hyogo Emergency Medical Center (Hyogo, Japan). They underwent emergency hemostasis by surgery and transcatheter arterial embolization...
April 2018: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29657372/targeted-interventions-in-critically-ill-children-with-severe-dengue
#4
Suchitra Ranjit, Gokul Ramanathan, Balasubramaniam Ramakrishnan, Niranjan Kissoon
Background: The World Health Organization guidelines provide suggestions on early recognition and treatment of severe dengue (SD); however, mortality in this group can be high and is related both to disease severity and the treatment complications. Subjects and Methods: In this prospective observational study, we report our results where standard therapy (ST) was enhanced by Intensive Care Unit (ICU) supportive measures that have proven beneficial in other conditions that share similar pathophysiology of capillary leak and fluid overload...
March 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29655553/transitional-care-post-tavi-a-pilot-initiative-focused-on-bridging-gaps-and-improving-outcomes
#5
Sandra Wong, Lorraine Montoya, Bonnie Quinlan
Interventions focused on ensuring safe transitions for patients from hospital to home can assist in providing continuity of care, preventing readmissions, and reducing duplication of services. Patients undergoing a Transcatheter Aortic Valve Implantation (TAVI) procedure are often frail, elderly, and have multiple co-morbidities. A pilot initiative evaluating transitional care strategies through telephone follow up was implemented in a tertiary centre with the aim to identify gaps and intervene, preventing re-admission and improving patient outcomes...
April 11, 2018: Geriatric Nursing
https://www.readbyqxmd.com/read/29653271/risk-factors-additional-length-of-stay-and-cost-associated-with-postoperative-ileus-following-anterior-lumbar-interbody-fusion-in-the-elderly
#6
Jason A Horowitz, Amit Jain, Varun Puvanesarajah, Rabia Qureshi, Hamid Hassanzadeh
OBJECTIVE: Identify the independent risk factors, additional length of stay, and additional cost associated with postoperative ileus following anterior lumbar interbody fusion in the elderly. METHODS: The PearlDiver Patient Records Database (Young & Ellison, LLC, Colorado Springs, CO) was queried for all Medicare patients 65 years of age and older undergoing 1 or 2 level primary elective anterior lumbar interbody fusion from 2005-2014. Independent risk factors, additional length of stay, and additional cost associated with postoperative ileus were evaluated with multivariate analysis...
April 10, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29643209/impacts-of-ocean-acidification-on-sea-urchin-growth-across-the-juvenile-to-mature-adult-life-stage-transition-is-mitigated-by-warming
#7
Symon A Dworjanyn, Maria Byrne
Understanding how growth trajectories of calcifying invertebrates are affected by changing climate requires acclimation experiments that follow development across life-history transitions. In a long-term acclimation study, the effects of increased acidification and temperature on survival and growth of the tropical sea urchin Tripneustes gratilla from the early juvenile (5 mm test diameter-TD) through the developmental transition to the mature adult (60 mm TD) were investigated. Juveniles were reared in a combination of three temperature and three pH/ p CO2 treatments, including treatments commensurate with global change projections...
April 11, 2018: Proceedings. Biological Sciences
https://www.readbyqxmd.com/read/29629980/development-of-an-enhanced-recovery-protocol-for-children-undergoing-gastrointestinal-surgery
#8
Mehul V Raval, Kurt F Heiss
PURPOSE OF REVIEW: Enhanced recovery protocols (ERPs) have been adopted for a variety of adult surgical conditions and resulted in markedly improved outcomes, including decreased length of stays, complications, costs, and narcotic utilization. In this review, we describe the development and implementation of an ERP for children undergoing gastrointestinal surgery. RECENT FINDINGS: Existing ERP components from adult and pediatric surgical populations were reviewed and modified through an iterative process that included literature review, a national survey of practicing pediatric surgeons, and appropriateness assessment by a multidisciplinary expert panel...
April 7, 2018: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/29628997/cancer-metabolism-new-insights-into-classic-characteristics
#9
REVIEW
Yasumasa Kato, Toyonobu Maeda, Atsuko Suzuki, Yuh Baba
Initial studies of cancer metabolism in the early 1920s found that cancer cells were phenotypically characterized by aerobic glycolysis, in that these cells favor glucose uptake and lactate production, even in the presence of oxygen. This property, called the Warburg effect, is considered a hallmark of cancer. The mechanism by which these cells acquire aerobic glycolysis has been uncovered. Acidic extracellular fluid, secreted by cancer cells, induces a malignant phenotype, including invasion and metastasis...
February 2018: Japanese Dental Science Review
https://www.readbyqxmd.com/read/29623629/impact-of-fluid-choice-in-systemic-inflammatory-response-syndrome-patients-on-hospital-cost-savings
#10
Suzanne Laplante, Dilip U Makhija, Sibyl H Munson, Victor S Khangulov, Fred W Peyerl, Scott M Paluszkiewicz, Aditi J Ravindranath, Carol R Schermer
BACKGROUND: There is growing evidence of the benefits of intravenous fluid therapy with balanced crystalloids over 0.9% 'normal' saline. This analysis evaluated the economic impact of increasing usage of a calcium-free balanced crystalloid solution (BAL) in patients with systemic inflammatory response syndrome (SIRS) on an annual hospital budget. METHODS: An Excel® -based economic model was developed to estimate costs associated with increased BAL usage (i.e., use in a greater proportion of patients), from the US hospital perspective, over a 5-year time horizon...
September 4, 2017: PharmacoEconomics Open
https://www.readbyqxmd.com/read/29619495/fournier-s-gangrene-in-an-obese-female-in-third-trimester-of-pregnancy
#11
Saqer Althunayyan, Evangelos Karamitosos
Fournier gangrene is a rapidly progressive necrotizing fasciitis of the perianal and genitourinary area. Although typically affects men, we present here a rare disease founding in a pregnant woman. An obese 36-year-old female patient in her third trimester of pregnancy presented with a history of perianal pain and swelling. She was subsequently diagnosed with Fournier gangrene and underwent emergency cesarean section with a surgical debridement. The key to successful outcomes in such a complicated presentation of Fournier gangrene includes a high index of suspicion, fluid resuscitation, rapid administration of broad-spectrum antibiotics, and an early interdisciplinary approach by multiple teams...
April 2018: Saudi Medical Journal
https://www.readbyqxmd.com/read/29617552/cassie-levitated-droplets-for-distortion-free-low-energy-solid-liquid-interactions
#12
William S Y Wong, Antonio Tricoli
Despite the rapid advent of superomniphobic materials, there is a lack of methodologies to accurately investigate the ultra-low energy interactions taking place on these interfaces. For instance, universally-employed models such as the pendant droplet often fail to provide representative information of the wetting properties of superomniphobic surfaces. The delicate balance between the forces acting at the droplet-surface and droplet-needle interfaces can easily result in heavily distorted droplet profiles...
April 4, 2018: ACS Applied Materials & Interfaces
https://www.readbyqxmd.com/read/29616878/integrating-competing-demands-of-osmoregulatory-and-thermoregulatory-homeostasis
#13
Michael J McKinley, Davide Martelli, Glenn L Pennington, David Trevaks, Robin M McAllen
Mammals are characterized by a stable core body temperature. When maintenance of core temperature is challenged by ambient or internal heat loads, mammals increase blood flow to the skin, sweat and/or pant, or salivate. These thermoregulatory responses enable evaporative cooling at moist surfaces to dissipate body heat. If water losses incurred during evaporative cooling are not replaced, body fluid homeostasis is challenged. This article reviews the way mammals balance thermoregulation and osmoregulation.
May 1, 2018: Physiology
https://www.readbyqxmd.com/read/29614588/-the-effect-of-continuous-veno-venous-hemofiltration-on-neutrophil-gelatinase-associated-lipocalin-plasma-levels-in-critically-ill-patients-with-acute-kidney-injury
#14
H Wang, N Cui, Y K Zhou, W Cheng, L Li, Y Long, D W Liu
Objective: To evaluate the effect of continuous veno venous hemofiltration (CVVH) on neutrophil gelatinase associated lipocalin (NGAL) in critically ill patients with acute kidney injury (AKI). Methods: Critically ill patients with AKI who needed CVVH and admitted to Department of Critical Care Medicine of Peking Union Medical College Hospital were enrolled prospectively from January 2015 to June 2015. AN69 membrane filters were used for CVVH. Prefilter, postfilter,and plasma NGAL measurements were taken at 10 mins, 4 hours and 8 hours (T 10 min, T 4 h, T 8 h) after CVVH...
April 1, 2018: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/29614002/expression-tissue-localization-and-serodiagnostic-potential-of-echinococcus-granulosus-leucine-aminopeptidase
#15
Maodi Wu, Min Yan, Jing Xu, Yuqing Liang, Xiaobin Gu, Yue Xie, Bo Jing, Weimin Lai, Xuerong Peng, Guangyou Yang
Echinococcus granulosus is the causative agent of cystic echinococcosis (CE), a widespread parasitic zoonosis. Leucine aminopeptidases (LAPs) of the M17 peptidase family have important functions in regulating the balance of catabolism and anabolism, cell maintenance, growth and defense. In this study, we presented a bioinformatic characterization and experimentally determined the tissue distribution characteristics of E. granulosus LAP (Eg-LAP), and explored its potential value for diagnosis of CE in sheep based on indirect ELISA...
April 3, 2018: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29610712/identification-of-three-classes-of-acute-respiratory-distress-syndrome-using-latent-class-analysis
#16
Zhongheng Zhang
Acute respiratory distress syndrome (ARDS) is a highly heterogeneous syndrome that can exhibit significant differences in the underlying causes, leading to different responses to treatment. It is required to identify subtypes of ARDS to guideline clinical treatment and trial design. The study aimed to identify subtypes of ARDS using latent class analysis (LCA). The study was a secondary analysis of the EDEN study, which was a randomized, controlled, multicenter trial conducted from January 2, 2008 to April 12, 2011...
2018: PeerJ
https://www.readbyqxmd.com/read/29603681/a-comparative-cfd-study-of-four-inferior-vena-cava-filters
#17
Josep M López, Gerard Fortuny, Dolors Puigjaner, Joan Herrero, Francesc Marimon
Computational fluid dynamics was used to simulate the flow of blood within an inferior vena cava (IVC) geometry model that was reconstructed from computed tomography images obtained from a real patient. The main novelty of the present work is that we simulated the implantation of four different filter models in this realistic IVC geometry. We considered different blood flow rates in the range between Vin =20 and Vin =80cm3 /s and all simulations were performed with both the Newtonian and a non-Newtonian model for the blood viscosity...
March 30, 2018: International Journal for Numerical Methods in Biomedical Engineering
https://www.readbyqxmd.com/read/29599805/qi-dong-huo-xue-yin-inhibits-inflammation-in-acute-lung-injury-in-mice-via-toll-like-receptor-4-caveolin-1-signaling
#18
Li-Ying Xu, Wan-Ru Cai, Chun-Fang Ma, Qi-Yang Shou, Jing-Li Qian, Turan S Huseyin
Acute lung injury (ALI) is a critical illness with no current effective treatment. Caveolin-1 indirectly activates inflammation-associated signaling pathways by inhibiting endothelial nitric oxide synthase (eNOS). This induces an imbalance between pro- and anti-inflammatory cytokine levels, which are involved in the pathogenesis of ALI. The compound Chinese prescription Qi-Dong-Huo-Xue-Yin (QDHXY) is efficacious for ALI treatment via an anti-inflammatory effect; however, the exact underlying mechanism is unknown...
2018: Evidence-based Complementary and Alternative Medicine: ECAM
https://www.readbyqxmd.com/read/29597221/technical-complications-of-continuous-renal-replacement-therapy
#19
Zaccaria Ricci, Stefano Romagnoli
Continuous renal replacement therapy (CRRT) is commonly applied in critically ill patients affected by severe acute kidney injury for solute and volume control and to optimize acid-base and electrolytes balance. Although CRRT represents a life-saving procedure for these patients, it is a representation of a non-physiologic artificial kidney and the potential benefits of the treatment could be hampered by clinical and technical side effects. Different parts of the CRRT system can be a source of technical complications...
2018: Contributions to Nephrology
https://www.readbyqxmd.com/read/29597218/membranes-and-sorbents
#20
William R Clark, Dayong Gao, Anna Lorenzin, Claudio Ronco
For continuous renal replacement therapy (CRRT), the extracorporeal filter provides solute depuration, fluid removal, and control of electrolyte and acid-base balance in critically ill patients with acute kidney injury (AKI). The membranes comprising CRRT filters are almost exclusively based on hollow fiber designs and, while adapted from the chronic hemodialysis field, have features that are specific to the requirements of CRRT nevertheless. In addition, these devices have evolved through the 40 years of CRRT in response to changes in clinical practice and the desire to extend the solute removal spectrum...
2018: Contributions to Nephrology
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