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Capillary refill time

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https://www.readbyqxmd.com/read/28345508/use-of-a-novel-portable-led-based-capillary-refill-time-simulator-within-a-disaster-triage-context
#1
Todd P Chang, Genevieve Santillanes, Ilene Claudius, Phung K Pham, James Koved, John Cheyne, Marianne Gausche-Hill, Amy H Kaji, Saranya Srinivasan, J Joelle Donofrio, Cynthia Bir
Introduction A simple, portable capillary refill time (CRT) simulator is not commercially available. This device would be useful in mass-casualty simulations with multiple volunteers or mannequins depicting a variety of clinical findings and CRTs. The objective of this study was to develop and evaluate a prototype CRT simulator in a disaster simulation context. METHODS: A CRT prototype simulator was developed by embedding a pressure-sensitive piezo crystal, and a single red light-emitting diode (LED) light was embedded, within a flesh-toned resin...
March 27, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28333326/new-high-dose-pulsed-hyaluronidase-protocol-for-hyaluronic-acid-filler-vascular-adverse-events
#2
Claudio DeLorenzi
The purpose of this article is to update the changes to the author's protocols used to manage acute filler related vascular events from those previously published in this journal. For lack of a better term, this new protocol has been called the High Dose Pulsed Hyaluronidase (HDPH) protocol for vascular embolic events with hyaluronic acid (HA) fillers. The initial protocol used involved many different modalities of treatment. The current protocol is exceedingly simple and involves solely the use of hyaluronidase in repeated high doses...
March 17, 2017: Aesthetic Surgery Journal
https://www.readbyqxmd.com/read/28306558/monitoring-of-the-physical-exam-in-sepsis
#3
Radu Postelnicu, Laura Evans
PURPOSE OF REVIEW: Monitoring of mental status and peripheral circulatory changes can be accomplished noninvasively in patients in the ICU. Emphasis on physical examination in conditions such as sepsis have gained increased attention as these evaluations can often serve as a surrogate marker for short-term treatment efficacy of therapeutic interventions. Sepsis associated encephalopathy and mental status changes correlate with worse prognosis in patients. Evaluation of peripheral circulation has been shown to be a convenient, easily accessible, and accurate marker for prognosis in patients with septic shock...
March 16, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28271546/factors-associated-with-survival-in-97-horses-with-septic-pleuropneumonia
#4
M G Arroyo, N M Slovis, G E Moore, S D Taylor
BACKGROUND: Septic pleuropneumonia is a common cause of morbidity and mortality in horses, but there is limited data available regarding factors associated with survival. HYPOTHESIS/OBJECTIVES: To identify factors predictive of survival in horses with septic pleuropneumonia. ANIMALS: A total of 97 horses with septic pleuropneumonia at 2 referral institutions. METHODS: A retrospective study was performed. A diagnosis of septic pleuropneumonia was based on the presence of sepsis, pleural effusion, and positive bacterial culture from tracheal aspiration (TA) or pleural fluid (PF)...
March 8, 2017: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/28248796/how-to-predict-oral-rehydration-failure-in-children-with-gastroenteritis
#5
Dorien Geurts, Ewout W Steyerberg, Henriëtte Moll, Rianne Oostenbrink
OBJECTIVES: Oral rehydration is the standard in most current guidelines for young children with acute gastroenteritis (AGE). Failure of oral rehydration can complicate the disease course, leading to morbidity due to severe dehydration. We aimed to identify prognostic factors of oral rehydration failure in children with AGE. METHODS: Design A prospective, observational study.Setting Emergency department (ED), Erasmus Medical Centre, Rotterdam, The Netherlands, 2010- 2012...
February 28, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28160731/immunological-clinical-haematological-and-oxidative-responses-to-long-distance-transportation-in-horses
#6
Barbara Padalino, Sharanne Lee Raidal, Nicole Carter, Pietro Celi, Gary Muscatello, Leo Jeffcott, Kumudika de Silva
Horses are transported frequently and often over long distances. Transportation may represent a physiological stressor with consequential health and welfare implications. This study reports the effects of a long distance journey on immunological, clinical, haematological, inflammatory and oxidative parameters in an Experimental Group (EG) of ten horses, comparing them with six horses of similar age and breed used as a non-transported Control Group (CG). Clinical examination and blood sampling were performed twice on all horses: immediately after unloading for the EG, and at rest on the same day for the CG (day 1); at rest on the same day one week later for both groups (day 7)...
January 31, 2017: Research in Veterinary Science
https://www.readbyqxmd.com/read/28143564/tranexamic-acid-in-bleeding-trauma-patients-an-exploration-of-benefits-and-harms
#7
Ian Roberts, Phil Edwards, David Prieto, Miland Joshi, Abda Mahmood, Katharine Ker, Haleema Shakur
BACKGROUND: The CRASH-2 trial showed that tranexamic acid (TXA) administration reduces mortality in bleeding trauma patients. However, the effect appeared to depend on how soon after injury TXA treatment was started. Treatment within 3 h reduced bleeding deaths whereas treatment after 3 h increased the risk. We examine how patient characteristics vary by time to treatment and explore whether any such variations explain the time-dependent treatment effect. METHODS: Exploratory analysis were carried out, including per-protocol analyses, of data from the CRASH-2 trial, a randomised placebo-controlled trial of the effect of TXA on mortality in 20,211 trauma patients with, or at risk of, significant bleeding...
January 31, 2017: Trials
https://www.readbyqxmd.com/read/28031190/risk-factors-for-death-in-children-during-inpatient-treatment-of-severe-acute-malnutrition-a-prospective-cohort-study
#8
Maren Jh Rytter, Esther Babirekere-Iriso, Hanifa Namusoke, Vibeke B Christensen, Kim F Michaelsen, Christian Ritz, Charlotte G Mortensen, Ezekiel Mupere, Henrik Friis
BACKGROUND: Children who receive in-hospital treatment of severe acute malnutrition often have high mortality rates, and the reasons are not well understood. OBJECTIVE: We assessed risk factors for death in children who were treated for malnutrition in a hospital. DESIGN: In a prospective observational study of 120 children who were receiving in-hospital treatment of severe acute malnutrition in Uganda with therapeutic formulas F-75 and F-100, we collected data on symptoms, clinical findings, plasma markers of refeeding syndrome (electrolytes and phosphate), and acute phase reactants, and recorded the nutritional therapy given in hospital...
February 2017: American Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/27940191/the-power-of-flash-mob-research-conducting-a-nationwide-observational-clinical-study-on-capillary-refill-time-in-a-single-day
#9
Jelmer Alsma, Jan Lcm van Saase, Prabath Wb Nanayakkara, Wem Ineke Schouten, Anique Baten, Martijn P Bauer, Frits Holleman, Jack Jm Ligtenberg, Patricia M Stassen, Karin A Kaasjager, Harm Haak, Frank H Bosch, Stephanie Ce Schuit
BACKGROUND: Capillary refill time (CRT) is a clinical test used to evaluate the circulatory status of patients, and there are various methods to assess CRT. Conventional clinical research often demands large numbers of patients, making it costly, labor-intensive and time consuming. We studied the interobserver agreement on CRT in a nationwide study using a novel methodology of research called 'Flash Mob Research' (FMR). METHODS: Physicians in the Netherlands were recruited by word-of-mouth, conventional media and social media to participate in a nationwide, single-day, "nine-to-five", multi-center, cross-sectional, observational study to evaluate CRT...
December 6, 2016: Chest
https://www.readbyqxmd.com/read/27908340/end-points-of-sepsis-resuscitation
#10
REVIEW
John C Greenwood, Clinton J Orloski
Resuscitation goals for the patient with sepsis and septic shock are to return the patient to a physiologic state that promotes adequate end-organ perfusion along with matching metabolic supply and demand. Ideal resuscitation end points should assess the adequacy of tissue oxygen delivery and oxygen consumption, and be quantifiable and reproducible. Despite years of research, a single resuscitation end point to assess adequacy of resuscitation has yet to be found. Thus, the clinician must rely on multiple end points to assess the patient's overall response to therapy...
February 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/27789509/capillary-refill-time-in-sick-children-a-clinical-guide-for-general-practice
#11
Susannah Fleming, Peter J Gill, Ann Van den Bruel, Matthew Thompson
No abstract text is available yet for this article.
November 2016: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/27768578/a-prospective-observational-study-to-assess-the-use-of-thermography-to-predict-progression-of-discolored-intact-skin-to-necrosis-among-patients-in-skilled-nursing-facilities
#12
Jill Cox, Loretta Kaes, Miguel Martinez, Daniel Moles
Skin temperature may help prospectively determine whether an area of skin discoloration will evolve into necrosis. A prospective, observational study was conducted in 7 skilled nursing facilities to determine if skin temperature measured using infrared thermography could predict the progression of discolored intact skin (blanchable erythema, Stage 1 pressure ulcer, or sus- pected deep tissue injury [sDTI]) to necrosis and to evaluate if nurses could effectively integrate thermography into the clinical setting...
October 2016: Ostomy/wound Management
https://www.readbyqxmd.com/read/27539601/in-vivo-dynamic-analysis-of-water-refilling-in-embolized-xylem-vessels-of-intact-zea-mays-leaves
#13
Jeongeun Ryu, Bae Geun Hwang, Sang Joon Lee
BACKGROUND AND AIMS: The refilling of embolized xylem vessels under tension is a major issue in water transport among vascular plants. However, xylem embolism and refilling remain poorly understood because of technical limitations. Direct observation of embolism repair in intact plants is essential to understand the biophysical aspects of water refilling in embolized xylem vessels. This paper reports on details of the water refilling process in leaves of the intact herbaceous monocot plant Zea mays and its refilling kinetics obtained by a direct visualization technique...
August 18, 2016: Annals of Botany
https://www.readbyqxmd.com/read/27484695/targeted-tissue-perfusion-versus-macrocirculation-guided-standard-care-in-patients-with-septic-shock-tartare-2s-study-protocol-and-statistical-analysis-plan-for-a-randomized-controlled-trial
#14
Ville Pettilä, Tobias Merz, Erika Wilkman, Anders Perner, Sari Karlsson, Theis Lange, Johanna Hästbacka, Peter Buhl Hjortrup, Anne Kuitunen, Stephan M Jakob, Jukka Takala
BACKGROUND: Septic shock has a 90-day mortality risk of up to 50 %. The hemodynamic targets, including mean arterial pressure (MAP) are not based on robust clinical data. Both severe hypotension and high doses of vasopressors may be harmful. Hence, re-evaluation of hemodynamic targets in septic shock is relevant. METHODS/DESIGN: The targeted tissue perfusion versus macrocirculation-guided standard care in patients with septic shock (TARTARE-2S) trial is a prospective, two-parallel-group, randomized, open-label, multicenter trial with assessor-blinded outcome evaluation...
August 2, 2016: Trials
https://www.readbyqxmd.com/read/27437676/capillary-refill-time-in-febrile-neutropenia
#15
Adriana Gherardi da Ponte, Rafael Henrique Jácomo
INTRODUCTION: Febrile neutropenia is a major cause of morbidity and mortality in patients presenting this condition following chemotherapy against several malignancies. OBJECTIVE: To evaluate if capillary refill time (CRT) allows the prediction of poor clinical outcome with or without antibiotic dose escalation. METHOD: Capillary refill time was assessed in 50 patients with febrile neutropenia at its nadir after chemotherapy admitted to the emergency department at Hospital Universitário de Brasília...
July 2016: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/27401441/toe-to-room-temperature-gradient-correlates-with-tissue-perfusion-and-predicts-outcome-in-selected-critically-ill-patients-with-severe-infections
#16
Simon Bourcier, Claire Pichereau, Pierre-Yves Boelle, Safaa Nemlaghi, Vincent Dubée, Gabriel Lejour, Jean-Luc Baudel, Arnaud Galbois, Jean-Rémi Lavillegrand, Naïke Bigé, Jalel Tahiri, Guillaume Leblanc, Eric Maury, Bertrand Guidet, Hafid Ait-Oufella
BACKGROUND: Microcirculatory disorders leading to tissue hypoperfusion play a central role in the pathophysiology of organ failure in severe sepsis and septic shock. As microcirculatory disorders have been identified as strong predictive factors of unfavourable outcome, there is a need to develop accurate parameters at the bedside to evaluate tissue perfusion. We evaluated whether different body temperature gradients could relate to sepsis severity and could predict outcome in critically ill patients with severe sepsis and septic shock...
December 2016: Annals of Intensive Care
https://www.readbyqxmd.com/read/27339165/comparison-of-peripheral-and-central-capillary-refill-time-in-febrile-children-presenting-to-a-paediatric-emergency-department-and-its-utility-in-identifying-children-with-serious-bacterial-infection
#17
Evelien de Vos-Kerkhof, Tarik Krecinic, Yvonne Vergouwe, Henriëtte A Moll, Ruud G Nijman, Rianne Oostenbrink
OBJECTIVE: To determine the agreement between peripheral and central capillary refill time (pCRT/cCRT) and their diagnostic values for detecting serious bacterial infection (SBI) in febrile children attending the paediatric emergency department (ED). DESIGN: Prospective observational study. SETTING: Paediatric ED, Erasmus Medium Care-Sophia Children's hospital, the Netherlands. PATIENTS: 1193 consecutively included, previously healthy, febrile children (1 month-16 years) with both pCRT measurements and cCRT measurements available...
January 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/27135829/factors-associated-with-streptococcal-bacteremia-in-diarrheal-children-under-five-years-of-age-and-their-outcome-in-an-urban-hospital-in-bangladesh
#18
Abu Sadat Mohammad Sayeem Bin Shahid, Tahmeed Ahmed, K M Shahunja, Senjuti Kabir, Fahmida Chowdhury, Abu Syeed Golam Faruque, Sumon Kumar Das, Mohammad Habibur Rahman Sarker, Pradip Kumar Bardhan, Mohammod Jobayer Chisti
BACKGROUND: Although Streptococcal bacteremia is common in diarrheal children with high morbidity and mortality, no systematic data are available on Streptococcal bacteremia in diarrheal children. We sought to evaluate the factors associated with Streptococcal bacteremia in diarrheal children under five years of age and their outcome. METHODS: We used an unmatched case-control design to investigate the associated factors with Streptococcal bacteremia in all the diarrheal children under five years of age through electronic medical record system of Dhaka hospital of International Centre for Diarrhoeal Disease Research, Bangladesh...
2016: PloS One
https://www.readbyqxmd.com/read/27123542/impact-of-mode-of-delivery-on-skin-microcirculation-in-term-healthy-newborns-within-the-first-day-of-life
#19
Ferit Kulali, Ebru Ergenekon, Selma Aktas, Ebru Kazanci, Sezin Unal, İbrahim Hirfanoğlu, Esra Önal, Canan Türkyilmaz, Esin Koç, Yildiz Atalay
BACKGROUND: Microcirculation is an important component of hemodynamic physiology. It can be assessed simply by clinical scores or by a variety of techniques including sidestream dark field (SDF) imaging and peripheral perfusion index (PI) measurements. Mode of delivery may have affects on microcirculation during transitional period. The aim of this study was to compare skin microcirculation in newborns born via vaginal delivery (VD) or cesarian section (C/S). METHODS: Term healthy newborns not requiring NICU admission were included...
March 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27053570/cercopithecine-herpesvirus-9-simian-varicella-virus-infection-after-total-body-irradiation-in-a-rhesus-macaque-macaca-mulatta
#20
Jatinder Gulani, Amory Koch, Mark G Chappell, Christine L Christensen, Paul Facemire, Vijay K Singh, Natalia I Ossetrova, Venkataraman Srinivasan, Rebecca K Holt
This case report describes a rhesus macaque (Macaca mulatta; male; age, 5 y; weight, 6.7 kg) with anorexia, dehydration, lethargy, ataxia, and generalized skin rashes that occurred 30 d after total-body irradiation at 6.5 Gy ((60)Co γ-rays). Physical examination revealed pale mucus membranes, a capillary refill time of 4 s, heart rate of 180 bpm. and respirations at 50 breaths per minute. Diffuse multifocal maculopapulovesicular rashes were present on the body, including mucocutaneous junctions. The CBC analysis revealed a Hct of 48%, RBC count of 6...
April 2016: Comparative Medicine
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