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https://www.readbyqxmd.com/read/29788836/intracranial-hemorrhage-in-adults-on-ecmo
#1
Yiorgos Alexandros Cavayas, Lorenzo Del Sorbo, Eddy Fan
RATIONALE: Extracorporeal membrane oxygenation (ECMO) use has exploded over the last decade. However, it remains invasive and associated with significant complications, including tamponade, infection, thrombosis, gas embolism and bleeding. The most dreaded complication is intracranial hemorrhage (ICH). In this article, we review the literature on the incidence, diagnosis, risk factors, pathophysiology, prognosis, prevention and management of ICH in adults on ECMO. MAIN FINDINGS: We found a high incidence of ICH in the literature with a poor prognosis...
May 2018: Perfusion
https://www.readbyqxmd.com/read/29786457/xanthine-oxidase-inhibitors-and-sepsis
#2
Maria Fátima de Paula Ramos, Alceni do Carmo Morais Monteiro de Barros, Clara Versolato Razvickas, Fernanda T Borges, Nestor Schor
Xanthine oxidase activation occurs in sepsis and results in the generation of uric acid (UrAc) and reactive oxygen species (ROS). We aimed to evaluate the effect of xanthine oxidase inhibitors (XOis) in rats stimulated with lipopolysaccharide (LPS). LPS (10 mg/kg) was administered intraperitoneally (i.p.) immediately after allopurinol (Alo, 2 mg/kg) or febuxostat (Feb, 1 mg/kg) every 24 h for 3 days. To increase UrAc levels, oxonic acid (Oxo) was administered by gavage (750 mg/kg per day) for 5 days...
January 2018: International Journal of Immunopathology and Pharmacology
https://www.readbyqxmd.com/read/29783255/management-of-the-patients-with-blunt-renal-trauma-20-years-of-clinical-experience
#3
Leonid P Sarychev, Yaroslav V Sarychev, Hanna L Pustovoyt, Sergiy A Sukhomlin, Sergiy M Suprunenko
OBJECTIVE: Introduction: Blunt renal trauma (BRT) is a dangerous medical condition. The aim: Analysis of effectiveness of conservative and expectant treatment tactics under ultrasound and CT monitoring in patients with blunt renal trauma (BRT). PATIENTS AND METHODS: Materials and methods: The results of treatment of 81 patients with BRT during 20 years (1998-2017) were analyzed. Amount of men was 58 (71.6%), women - 23 (28.4%). Grade I trauma was seen in 37.0% of cases, grade II - in 25...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29780817/clinical-profile-and-outcome-of-patients-with-acute-kidney-injury-requiring-hemodialysis-two-years-experience-at-a-tertiary-hospital-in-rwanda
#4
Grace Igiraneza, Benedicte Ndayishimiye, Menelas Nkeshimana, Vincent Dusabejambo, Onyema Ogbuagu
Introduction: Acute kidney injury (AKI) requiring renal replacement therapy is associated with high mortality. The study assessed the impact of the introduction of hemodialysis (HD) on outcomes of patients with AKI in Rwanda. Methods: A single center retrospective study that evaluated the clinical profile and survival outcomes of patients with AKI requiring HD [AKI-D] at a tertiary hospital in Rwanda. Data was collected on patients who received HD for AKI from September 2014 to December 2016...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29780607/renal-cell-carcinoma-in-a-cat-with-polycystic-kidney-disease-undergoing-renal-transplantation
#5
Daniel J Adams, Jolie A Demchur, Lillian R Aronson
Case summary: A 10-year-old spayed female American Shorthair cat underwent renal transplantation due to worsening chronic kidney disease secondary to polycystic kidney disease. During transplantation, the right kidney grossly appeared to be more diseased than the left and was firmly adhered to the surrounding tissues. An intraoperative fine-needle aspirate of the right native kidney revealed inflammatory cells but no evidence of neoplasia. To create space for the allograft, a right nephrectomy was performed...
January 2018: JFMS Open Reports
https://www.readbyqxmd.com/read/29779449/continuous-cytokine-haemoadsorption-incorporated-into-a-venoarterial-ecmo-circuit-for-the-management-of-postcardiotomy-cardiogenic-and-septic-shock-a-case-report
#6
Endre Nemeth, Szabolcs Szigeti, Tamas Varga, Laszlo Daroczi, Zoltan Barati, Bela Merkely, Janos Gal
INTRODUCTION: The acute surgical treatment of infective endocarditis (IE) carries a high risk of postoperative mortality. Most complications are linked to uncontrolled sepsis and inflammatory processes. Cytokine haemoadsorption is an extracorporeal technique which has benefits reported in haemodynamic stability and inflammatory response. CASE REPORT: A 46-year-old male patient underwent emergency cardiac surgery due to progressive IE. Postcardiotomy cardiogenic shock associated with cardiac surgery required the implantation of venoarterial (VA)-ECMO...
May 1, 2018: Perfusion
https://www.readbyqxmd.com/read/29778493/retrograde-ureteral-catheterization-a-possible-new-treatment-for-renal-fungal-balls-in-very-low-birth-weight-infants
#7
Cheng-Wei Chen, Chyong-Hsin Hsu, Jin-Cherng Sheu, Hsin Chi, Jui-Hsing Chang, Chun-Chen Lin, Jeng-Daw Tsai
Invasive candidiasis is a serious pathogen of late-onset sepsis in very-low-birth- weight (VLBW) infants. Kidney is the most common organ involved and it causes morbidity and mortality, especially when fungal balls are formed. We report a 34-day-old female infant (28 weeks, 1152 gm) with systemic fungal infection complicated obstructive uropathy. On sonography, the fungal balls filled the entire pelvis without hydronephrosis. Percutaneous nephrostomy was not feasible. In addition to systemic antifungals, we successfully performed cystoscopy-assisted retrograde ureteral catheterization (RUC) to decompress the pelvis, which also provided a route for local amphotericin B irrigation to achieve therapeutic concentration without nephrotoxicity...
May 17, 2018: Urology
https://www.readbyqxmd.com/read/29777456/distal-bowel-re-feeding-in-patients-with-proximal-jejunostomy
#8
Anand Nagar, Siddharth Mehrotra, Amitabh Yadav, Vivek Mangla, Shailendra Lalwani, Naimish Mehta, Samiran Nundy
BACKGROUND: Patients who have a proximal jejunostomy are difficult to manage because of their high stoma output which results in fluid and electrolyte imbalance with repeated hospital admissions and the necessity for expensive parenteral nutrition (PN). There are few reports on the use of re-feeding of the proximal effluents in this situation. METHODS: We here relate our experience with this manoeuvre in 35 patients between Jan 2010 and Feb 2016 who had stomas less than 120 cm away from the duodenojejunal flexure...
May 18, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29776670/-predictors-of-in-hospital-mortality-in-patients-undergoing-elective-surgery-in-a-university-hospital-a-prospective-cohort
#9
Adriene Stahlschmidt, Betânia Novelo, Luiza Alexi Freitas, Sávio Cavalcante Passos, Jairo Alberto Dussián-Sarria, Elaine Aparecida Félix, Patrícia Wajnberg Gamermann, Wolnei Caumo, Luciana Paula Cadore Stefani
INTRODUCTION: Morbidity and mortality associated with urgent or emergency surgeries are high compared to elective procedures. Perioperative risk scores identify the non-elective character as an independent factor of complications and death. The present study aims to characterize the population undergoing non-elective surgeries at the Hospital de Clínicas de Porto Alegre and identify the clinical and surgical factors associated with death within 30 days postoperatively. METHODOLOGY: A prospective cohort study of 187 patients undergoing elective surgeries between April and May 2014 at the Hospital de Clínicas, Porto Alegre...
May 15, 2018: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/29771701/dynamic-contrast-enhanced-ultrasound-identifies-microcirculatory-alterations-in-sepsis-induced-acute-kidney-injury
#10
Alexandre Lima, Tom van Rooij, Bulent Ergin, Michele Sorelli, Yasin Ince, Patricia A C Specht, Egbert G Mik, Leonardo Bocchi, Klazina Kooiman, Nico de Jong, Can Ince
OBJECTIVES: We developed quantitative methods to analyze microbubble kinetics based on renal contrast-enhanced ultrasound imaging combined with measurements of sublingual microcirculation on a fixed area to quantify early microvascular alterations in sepsis-induced acute kidney injury. DESIGN: Prospective controlled animal experiment study. SETTING: Hospital-affiliated animal research institution. SUBJECTS: Fifteen female pigs...
May 15, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29766208/-adequate-anti-infective-treatment-importance-of-individual-dosing-and-application
#11
A Brinkmann, A C Röhr, A Köberer, T Fuchs, W A Krüger, C König, D Richter, M A Weigand, O R Frey
Sepsis-induced changes in pharmacokinetic parameters are a well-known problem in intensive care medicine. Dosing of antibiotics in this setting is therefore challenging. Alterations to the substance-specific kinetics of anti-infective substances have an effect on the distribution and excretion processes in the body. Increased clearance and an increased distribution volume (Vd ) and particularly compromized organ function with reduced antibiotic elimination are often encountered in patients with sepsis. Renal replacement treatment, which is frequently used in intensive care medicine, represents a substantial intervention in this system...
May 15, 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29762410/renal-blood-flow-measurement-in-early-clinical-sepsis-can-you-catch-a-shadow
#12
John R Prowle
No abstract text is available yet for this article.
June 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29761676/planned-re-laparotomy-in-a-non-trauma-setting-a-single-center-experience
#13
Yehuda Hershkovitz, Itamar Ashkenazi, Zahar Shapira, Oded Zmora, Igor Jeroukhimov
BACKGROUND: Damage control laparotomy (DCL) is the widely accepted procedure of choice in management of severely injured trauma patient. It has been implemented in non-trauma-related surgical pathology in the last decade. OBJECTIVES: To evaluate our experience with planned re-laparotomy (PRL) in non-trauma patients and compare it to other reports. METHODS: Charts of all patients admitted to Assaf Harofeh Medical Center who underwent PRL for non-trauma-related abdominal pathology during a 6 year period were reviewed...
May 2018: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/29756955/multicenter-study-of-parenteral-nutrition-in-non-critically-ill-elderly-patients-compared-to-younger-patients-study-iaios-pn-incidence-and-assessment-of-iatrogenesis-in-older-subjects-receiving-parenteral-nutrition
#14
Javier Mateu-de Antonio, David Berlana, Montserrat Pons-Bussom, Maria B Badia-Tahull, María Teresa Miana-Mena, Beatriz Martínez-Castro, Neus Sunyer-Esquerrà, Mónica Sanmartin-Suñer, Juan González-Valdivieso, Elisabet Leiva-Badosa, Eva Martínez-Bernabé, Anna Murgadella-Sancho, Nuria Mirerachs-Aranda, Anna Vila-Bundó, Jordi Fernández-Morató, María Teresa Vitales-Farrero
OBJECTIVE: this study assessed the incidence of hyperglycemia, hypertriglyceridemia, and liver function test (LFT) alterations among patients older and younger than 65 years receiving parenteral nutrition (PN). A secondary objective was to compare the incidence of any of these three events. MATERIAL AND METHODS: inclusion criteria were non-critically ill adult inpatients receiving PN for ≥ 7 days in 15 hospitals in Spain. Exclusion criteria were hyperglycemia, hypertriglyceridemia, LFT alterations, sepsis, shock, pancreatic/hepatobiliary surgery, renal failure, diabetes mellitus (DM) type 1, insulin-treated DM type 2, acute DM complications, or obesity prior to PN...
February 27, 2018: Nutrición Hospitalaria: Organo Oficial de la Sociedad Española de Nutrición Parenteral y Enteral
https://www.readbyqxmd.com/read/29755574/branched-chain-amino-acids-in-health-and-disease-metabolism-alterations-in-blood-plasma-and-as-supplements
#15
REVIEW
Milan Holeček
Branched-chain amino acids (BCAAs; valine, leucine, and isoleucine) are essential amino acids with protein anabolic properties, which have been studied in a number of muscle wasting disorders for more than 50 years. However, until today, there is no consensus regarding their therapeutic effectiveness. In the article is demonstrated that the crucial roles in BCAA metabolism play: (i) skeletal muscle as the initial site of BCAA catabolism accompanied with the release of alanine and glutamine to the blood; (ii) activity of branched-chain keto acid dehydrogenase (BCKD); and (iii) amination of branched-chain keto acids (BCKAs) to BCAAs...
2018: Nutrition & Metabolism
https://www.readbyqxmd.com/read/29755348/the-fibrin-cleavage-product-b%C3%AE-15-42-channels-endothelial-and-tubular-regeneration-in-the-post-acute-course-during-murine-renal-ischemia-reperfusion-injury
#16
Dania Fischer, Christopher Seifen, Patrick Baer, Michaela Jung, Christina Mertens, Bertram Scheller, Kai Zacharowski, Rainer Hofmann, Thorsten J Maier, Anja Urbschat
Early and adequate restoration of endothelial and tubular renal function is a substantial step during regeneration after ischemia reperfusion (IR) injury, occurring, e.g., in kidney transplantation, renal surgery, and sepsis. While tubular epithelial cell injury has long been of central importance, recent perception includes the renal vascular endothelium. In this regard, the fibrin cleavage product fibrinopeptide Bβ15-42 mitigate IR injury by stabilizing interendothelial junctions through its affinity to VE-cadherin...
2018: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/29753570/xanthogranulomatous-pyelonephritis-a-complicated-febrile-urinary-tract-infection-detected-by-point-of-care-ultrasound-in-the-emergency-department
#17
Ryan Gibbons, Nicole Leonard, Mark Magee, Allison Zanaboni, Jessica Patterson, Thomas Costantino
BACKGROUND: Febrile urinary tract infections (UTIs) include a spectrum of pathologies from uncomplicated pyelonephritis to urosepsis, including xanthogranulomatous pyelonephritis (XGP). Most febrile UTIs are treated with antibiotics alone, but studies indicate nearly 12% of cases of presumed simple pyelonephritis require emergent urologic intervention. How to identify these individuals, while limiting unnecessary advanced imaging and delays in diagnosis, challenges all emergency providers...
May 9, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29753542/children-with-chronic-disease-bear-the-highest-burden-of-pediatric-sepsis
#18
Andrew J Prout, Victor B Talisa, Joseph A Carcillo, Florian B Mayr, Derek C Angus, Christopher W Seymour, Chung-Chou H Chang, Sachin Yende
OBJECTIVE: To describe the contemporary epidemiology of pediatric sepsis in children with chronic disease, and the contribution of chronic diseases to mortality. We examined the incidence and hospital mortality of pediatric sepsis in a nationally representative sample and described the contribution of chronic diseases to hospital mortality. STUDY DESIGN: We analyzed the 2013 Nationwide Readmissions Database using a retrospective cohort design. We included non-neonatal patients <19 years of age hospitalized with sepsis...
May 9, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29751278/pregnancy-related-acute-kidney-injury-requiring-dialysis-as-an-indicator-of-severe-adverse-maternal-morbidity-at-a-tertiary-center-in-southwest-nigeria
#19
Ibraheem O Awowole, Oluseyi S Omitinde, Fatiu A Arogundade, Sekinah B Bola-Oyebamiji, Olumide A Adeniyi
OBJECTIVE: Despite being a Critical Intervention in the WHO Near-miss concept, the indications and clinical outcomes of patients with Pregnancy-Related Acute Kidney Injury (PRAKI) requiring dialysis at the Obafemi Awolowo University Teaching Hospitals Complex, Nigeria remain unknown. This retrospective review was conducted to facilitate counselling, prognostication and introduction of preventative measures by providing contemporary data on the aetiology and clinical outcomes of women with PRAKI...
May 2, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29750814/one-year-mortality-after-recovery-from-critical-illness-a-retrospective-cohort-study
#20
Sharukh Lokhandwala, Ned McCague, Abdullah Chahin, Braiam Escobar, Mengling Feng, Mohammad M Ghassemi, David J Stone, Leo Anthony Celi
RATIONALE: Factors associated with one-year mortality after recovery from critical illness are not well understood. Clinicians generally lack information regarding post-hospital discharge outcomes of patients from the intensive care unit, which may be important when counseling patients and families. OBJECTIVE: We sought to determine which factors among patients who survived for at least 30 days post-ICU admission are associated with one-year mortality. METHODS: Single-center, longitudinal retrospective cohort study of all ICU patients admitted to a tertiary-care academic medical center from 2001-2012 who survived ≥30 days from ICU admission...
2018: PloS One
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