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Joon Woo Lee, Chan Ik Park, Hyung Il Kim, Oh Hyun Kim, Kyoung Chul Cha, Hyun Kim, Kang Hyun Lee, Sung Oh Hwang, Yong Sung Cha
OBJECTIVE: When managing patients with acute meningitis in an emergency department (ED), early diagnosis of the type of infection (bacterial or viral) considerably affects the clinical course and treatment because of the high mortality and morbidity associated with bacterial meningitis (BM). The serum delta neutrophil index (DNI), a new inflammatory marker, reflects the fraction of circulating immature granulocytes and is elevated in cases of bacterial infection. The objective of this study was to evaluate whether serum DNI can be used to differentiate between BM and viral meningitis (VM) in the ED...
June 2016: Clin Exp Emerg Med
Stanislaw Sobotka, Jingming Chen, Themba Nyirenda, Liancai Mu
Background Our recent work has demonstrated that the native motor zone (NMZ) within a given skeletal muscle is the best site for muscle reinnervation. This study was designed to explore the outcomes of direct nerve implantation (DNI) into the NMZ of denervated sternomastoid (SM) muscle in a rat model. Methods The right SM muscle was experimentally denervated by transecting its innervating nerve. The proximal stump of the severed SM nerve was immediately implanted into a small muscle slit made in the NMZ of the muscle where denervated motor endplates were concentrated...
October 13, 2016: Journal of Reconstructive Microsurgery
Brian Clemency, Colleen Clemency Cordes, Heather A Lindstrom, Jeanne M Basior, Deborah P Waldrop
OBJECTIVES: What patients intend when they make health care choices and whether they understand the meaning of orders for life-sustaining treatment forms is not well understood. The purpose of this study was to analyze the directives from a sample of emergency department (ED) patients' MOLST forms. PROCEDURES: MOLST forms that accompanied 100 patients who were transported to an ED were collected and their contents analyzed. Data categories included age, gender, if the patient completed the form for themselves, medical orders for life-sustaining treatment including intubation, ventilation, artificial nutrition, artificial fluids or other treatment, and wishes for future hospitalization or transfer...
September 27, 2016: Journal of the American Medical Directors Association
Yong Sung Cha, Kang Hyun Lee, Jong Wook Lee, Woocheol Kwon, Seok Jeong Lee, Kyung Sik Kang, Hyung Il Kim, Oh Hyun Kim, Kyoung-Chul Cha, Hyun Kim, Sung Oh Hwang
BACKGROUND: Although respiratory infections, such as pneumonia, have long been recognized as precipitators of exacerbation in patients with acute decompensated heart failure (ADHF), identifying signs of concomitant pneumonia in ADHF is a clinical diagnostic challenge. We evaluated the predictive value of the delta neutrophil index (DNI), a new indicator for immature granulocytes, for diagnosing superimposed pneumonia in patients presenting with ADHF in the emergency department (ED). METHODS: This was a retrospective and observational study of consecutive patients (>18 years old) diagnosed with an ADHF in the ED over a 7-month period...
2016: PloS One
Christopher J Forgaard, Ian M Franks, Dana Maslovat, Nicolette J Gowan, Jonathan C Kim, Romeo Chua
Unexpected presentation of a startling auditory stimulus (SAS>120 decibels) in a reaction time (RT) paradigm results in the startle reflex and an early release (<100ms) of the preplanned motor response (StartReact effect). Mechanical perturbations applied to the upper limbs elicit short- (M1) and long-latency (M2) stretch reflexes and have also been shown to initiate intended motor responses early (<100ms). Ravichandran et al. (2013) recently proposed that unexpected delivery of a perturbation could also elicit a startle response and therefore the StartReact effect may be responsible for the early trigger of a preplanned response...
September 21, 2016: Neuroscience
Hyunchul Kim, Taeyoung Kong, Sung Phil Chung, Jung Hwa Hong, Jong Wook Lee, Youngseon Joo, Dong Ryul Ko, Je Sung You, Incheol Park
PURPOSE: Recent technological advances have led to analyses of the delta neutrophil index (DNI), which reflects the fraction of circulating immature granulocytes, using specific automated blood cell analysers. We evaluated the significance of the DNI as a prognostic marker for early severity in patients with acute cholangitis. METHODS: We retrospectively analysed patients initially diagnosed with acute cholangitis at emergency department (ED) admission, followed by diagnostic confirmation, during a set period...
August 24, 2016: Shock
Yusuke Takanashi, Takamitsu Hayakawa, Hiroshi Neyatani, Kazuhito Funai
Descending necrotizing mediastinitis (DNM) is a potentially lethal disease that originates from a deep neck infection (DNI); it is often associated with an immunocompromised state. Hyperimmunoglobulin E syndrome (HIES) is an extremely rare complex immune deficiency characterized by recurrent abscesses of staphylococcal etiology. A rare case of a 34-year-old woman wherein HIES putatively promoted the development of DNI into DNM is described. She presented with cervical purulent lymphadenitis and retropharyngeal abscess...
July 2016: Respirology Case Reports
Jose A Ruiz-Arias, Christian A Gueymard, Francisco J Santos-Alamillos, David Pozo-Vázquez
Concentrating solar technologies, which are fuelled by the direct normal component of solar irradiance (DNI), are among the most promising solar technologies. Currently, the state-of the-art methods for DNI evaluation use datasets of aerosol optical depth (AOD) with only coarse (typically monthly) temporal resolution. Using daily AOD data from both site-specific observations at ground stations as well as gridded model estimates, a methodology is developed to evaluate how the calculated long-term DNI resource is affected by using AOD data averaged over periods from 1 to 30 days...
2016: Scientific Reports
Sourav Biswas, Joydeb Goura, Sourav Das, Craig V Topping, Jamie Brambleby, Paul A Goddard, Vadapalli Chandrasekhar
Octanuclear heterobimetallic complexes, [Ln4Ni4(H3L)4(μ3-OH)4(μ2-OH)4]4Cl·xH2O·yCHCl3 (Dy(3+), x = 30.6, y = 2 (1); Tb(3+), x = 28, y = 0 (2) ; Gd(3+), x = 25.3, y = 0 (3); Ho(3+), x = 30.6, y = 3 (4)) (H5L = N1,N3-bis(6-formyl-2-(hydroxymethyl)-4-methylphenol)diethylenetriamine) are reported. These are assembled by the cumulative coordination action of four doubly deprotonated compartmental ligands, [H3L](2-), along with eight exogenous -OH ligands. Within the core of these complexes, four Ln(3+)'s are distributed to the four corners of a perfect square grid while four Ni(2+)'s are projected away from the plane of the Ln4 unit...
September 6, 2016: Inorganic Chemistry
Demetris Yannopoulos, Jason A Bartos, Cindy Martin, Ganesh Raveendran, Emil Missov, Marc Conterato, R J Frascone, Alexander Trembley, Kevin Sipprell, Ranjit John, Stephen George, Kathleen Carlson, Melissa E Brunsvold, Santiago Garcia, Tom P Aufderheide
BACKGROUND: In 2015, the Minnesota Resuscitation Consortium (MRC) implemented an advanced perfusion and reperfusion life support strategy designed to improve outcome for patients with out-of-hospital refractory ventricular fibrillation/ventricular tachycardia (VF/VT). We report the outcomes of the initial 3-month period of operations. METHODS AND RESULTS: Three emergency medical services systems serving the Minneapolis-St. Paul metro area participated in the protocol...
June 2016: Journal of the American Heart Association
Soo Young Cho, Jae Hee Woo, Yoon Jin Kim, Eun Hee Chun, Jong In Han, Dong Yeon Kim, Hee Jung Baik, Rack Kyung Chung
Securing the airway in patients undergoing surgical intervention to control a deep neck infection (DNI) is challenging for anesthesiologists due to the distorted airway anatomy, limited mouth opening, tissue edema, and immobility. It is critical to assess the risk of a potential difficult airway and prepare the most appropriate airway management method.We reviewed our anesthetic experiences managing patients with DNIs, focusing on the need for video-laryngoscope or awake fiberoptic intubation beyond a standard intubation from the anesthesiologist's perspective...
July 2016: Medicine (Baltimore)
Izabela Olejniczak, Katarzyna Bojanowska-Poźniak, Wioletta Pietruszewska
Deep neck infections (DNI) are serious problem because of variable clinical manifestations. This condition affects fascial compartments of the head and neck and organs that they contain. Nowadays the incidence of DNI have decreased because of antibiotics use and improvements in oral hygiene. But it may still lead to many life-threatening complications due to numerous portals of entry and proximity to vital structures. Furthermore, the inappropriate use of antibiotics, steroids, and nonsteroidal anti-inflammatory drugs may mask signs of infection and change the clinical presentation, and also lead to a different courses of disease...
April 30, 2016: Otolaryngologia Polska. the Polish Otolaryngology
M Vilaça, C Dias, I Aragão, G Campello
No abstract text is available yet for this article.
December 2015: Intensive Care Medicine Experimental
Yi-Xia Zhou, Li-Xin Shi, Hua Yang, Yi-Guo Long, L U Meng, Li-Sa Lv, Yang Zhang, Huan Yao, Long Li, Yan-Ni Yu
The present study aimed to investigate the effects of glycogen synthase kinase-3β (GSK-3β) on the expression levels of receptor activator of nuclear factor (NF)-κB (RANK), RANK ligand (RANKL) and NF-κB in the renal tissues of rats modeling diabetic nephropathy (DN). The rats were allocated at random into three groups, as follows: Normal control group (NC), the DN model group (DNM group) and the DN model lithium chloride (LiCl) intervention group (DNI group). Urinary proteins were examined by staining with the Coomassie Brilliant Blue dye for 24 h...
June 2016: Experimental and Therapeutic Medicine
Ines Maria Grazia Piroddi, Cornelius Barlascini, Antonio Esquinas, Fulvio Braido, Paolo Banfi, Antonello Nicolini
The treatment of acute respiratory failure with non-invasive ventilation (NIV) as a first-line therapy is increasingly common in intensive care units. The reduced invasiveness of NIV leads to better outcomes than endotracheal intubation in carefully selected groups of patients. Furthermore, the use of NIV as a palliative treatment for respiratory failure and dyspnea has become increasingly common. NIV also has an impact on the use of "do not intubate" orders. In the present narrative review, we explore the use and outcome of NIV in elderly patients...
May 23, 2016: Geriatrics & Gerontology International
Rémi Coudroy, Angéline Jamet, Philippe Petua, René Robert, Jean-Pierre Frat, Arnaud W Thille
BACKGROUND: Acute respiratory failure is the main cause of admission to intensive care unit in immunocompromised patients. In this subset of patients, the beneficial effects of noninvasive ventilation (NIV) as compared to standard oxygen remain debated. High-flow nasal cannula oxygen therapy (HFNC) is an alternative to standard oxygen or NIV, and its use in hypoxemic patients has been growing. Therefore, we aimed to compare outcomes of immunocompromised patients treated using HFNC alone or NIV as a first-line therapy for acute respiratory failure in an observational cohort study over an 8-year period...
December 2016: Annals of Intensive Care
Masaji Nishimura
High-flow nasal cannula (HFNC) oxygen therapy is carried out using an air/oxygen blender, active humidifier, single heated tube, and nasal cannula. Able to deliver adequately heated and humidified medical gas at flows up to 60 L/min, it is considered to have a number of physiological advantages compared with other standard oxygen therapies, including reduced anatomical dead space, PEEP, constant F(IO2), and good humidification. Although few large randomized clinical trials have been performed, HFNC has been gaining attention as an alternative respiratory support for critically ill patients...
April 2016: Respiratory Care
Olubode A Olufajo, Samir Tulebaev, Houman Javedan, Jonathan Gates, Justin Wang, Maria Duarte, Edward Kelly, Elizabeth Lilley, Ali Salim, Zara Cooper
BACKGROUND: Although involvement of geriatricians in the care of older trauma patients is associated with changes in processes of care and improved outcomes, few geriatrician consultations were ordered on our service. STUDY DESIGN: Mandatory geriatric consults were initiated in September 2013 for all trauma patients 70 years and older admitted to our hospital. We prospectively collected data on patients admitted from October 2013 through September 2014 (postintervention) and compared their data with those of patients admitted from June 2011 through June 2012 (preintervention)...
June 2016: Journal of the American College of Surgeons
Marta Vilaça, Irene Aragão, Teresa Cardoso, Cláudia Dias, Glória Cabral-Campello
BACKGROUND: Noninvasive ventilation (NIV) is being used increasingly in patients who have a "do not intubate" (DNI) order. However, the impact of NIV on the clinical and health-related quality of life (HRQOL) in the emergency setting is not known, nor is its effectiveness for relieving symptoms in end-of-life care. OBJECTIVE: The aim of this prospective study was to determine the outcome and HRQOL impact of regular use of NIV outcomes on patients with a DNI order who were admitted to the emergency room department (ED)...
2016: PloS One
Oh Hyun Kim, Yong Sung Cha, Sung Oh Hwang, Ji Young Jang, Eun Hee Choi, Hyung Il Kim, KyoungChul Cha, Hyun Kim, Kang Hyun Lee
BACKGROUND: In children with acute appendicitis, 30% to 75% present with a complication, such as perforation, and the early diagnosis of complications is known to improve outcomes. Serum delta neutrophil index (DNI) and myeloperoxidase index (MPXI) are new inflammatory markers, and thus, in the present study, the authors evaluated the predictive values of these two markers for the presence of a complication in children with acute appendicitis. METHODS: This retrospective observational study was conducted on 105 consecutive children (<12 years old) with acute appendicitis treated over a 31-month period...
2016: PloS One
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