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renal haemodynamics

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https://www.readbyqxmd.com/read/29876993/from-pregnancy-to-cardiovascular-disease-lessons-from-relaxin-deficient-animals-to-understanding-relaxin-actions-in-the-vascular-system
#1
Maria Jelinic, Sarah A Marshall, Chen Huei Leo, Laura J Parry, Marianne Tare
Early maternal vascular adaptations to pregnancy are predominantly driven by changes in vascular tone, reactivity and remodelling. Failure of the maternal systemic vasculature to adapt sufficiently can lead to serious complications of pregnancy. The hormone relaxin is widely recognised for its contribution to the essential renal and systemic haemodynamic adaptations in early pregnancy through direct actions on the maternal vasculature. Studies in relaxin gene knockout mice revealed that endogenous relaxin is not only a 'pregnancy hormone' but has pleiotropic actions in various tissues in males and non-pregnant females...
June 7, 2018: Microcirculation: the Official Journal of the Microcirculatory Society, Inc
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
#2
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/29772567/the-renin-angiotensin-system-not-the-kinin-kallikrein-system-affects-post-exercise-proteinuria
#3
Günnur Koçer, Filiz Basralı, Oktay Kuru, Ümit Kemal Şentürk
BACKGROUND/AIMS: Temporary proteinuria post-exercise is common and is caused predominantly by renal haemodynamic alterations. One reason is up-regulation of angiotensin II (Ang II) due to the reducing effect of angiotensin-converting enzyme (ACE) inhibitors. However, another, ignored, reason could be the kininase effect of ACE inhibition. This study investigated how ACE inhibition reduces post-exercise proteinuria: by either Ang II up-regulation inhibition or bradykinin elevation due to kininase activity inhibition...
May 17, 2018: Nephron
https://www.readbyqxmd.com/read/29756690/preoperative-predictive-model-for-acute-kidney-injury-after-elective-cardiac-surgery-a-prospective-multicentre-cohort-study
#4
Raquel Callejas, Alfredo Panadero, Marc Vives, Paula Duque, Gemma Echarri, Pablo Monedero
BACKGROUND: Predictive models of CS-AKI include emergency surgery and patients with haemodynamic instability. Our objective was to evaluate the performance of validated predictive models (Thakar and Demirjian) in elective cardiac surgery and to propose a better score in the case of poor performance. METHODS: A prospective, multicentre, observational study was designed. Data were collected from 942 patients undergoing cardiac surgery, after excluding emergency surgery and patients with an intraaortic balloon pump...
May 11, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29753653/cardiopulmonary-bypass-in-non-cardiac-surgery
#5
Timothy Luke Surman, Michael George Worthington, Jose Martinelli Nadal
BACKGROUND: Cardiopulmonary bypass (CPB) and extracorporeal membrane oxygenation (ECMO) are used to facilitate circulatory support in standard cardiac surgery and emergency intervention, but CPB and ECMO are not used routinely in non-cardiac surgery involving the thorax and major vessels. The primary aim of this study was to identify the type of non-cardiac procedures and bypass used in our institution and review the patient outcomes including perioperative and bypass complications. METHODS: A retrospective study was performed within the Royal Adelaide Hospital Cardiothoracic Surgery Unit (CTSU) that examined all operations between 2006 and 2014...
April 19, 2018: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29745623/the-role-of-intraoperative-stroke-volume-variation-on-bleeding-during-functional-endoscopic-sinus-surgery
#6
Roberta Di Mauro, Fabiana Lucci, Federica Martino, Maria B Silvi, Eleonora Gidaro, Santo Di Lorenzo, Nicola Toschi, Stefano Di Girolamo, Mario Dauri
BACKGROUNDː Functional Endoscopic Sinus Surgery (FESS) is a minimally-invasive surgical technique for patients with paranasal sinus pathology. Surgical bleeding reduces operative field visibility and increases the incidence of serious complications. Epinephrine injection into the nasal mucosa and controlled hypotension are used to minimise bleeding. Hypotension carries risks and sometimes does not reduce surgical bleeding. The goal of this study is to discover which haemodynamic parameter better correlates with surgical bleeding...
May 9, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29682559/hemodynamic-instability-during-dialysis-the-potential-role-of-intradialytic-exercise
#7
REVIEW
Scott McGuire, Elizabeth Jane Horton, Derek Renshaw, Alofonso Jimenez, Nithya Krishnan, Gordon McGregor
Acute haemodynamic instability is a natural consequence of disordered cardiovascular physiology during haemodialysis (HD). Prevalence of intradialytic hypotension (IDH) can be as high as 20-30%, contributing to subclinical, transient myocardial ischemia. In the long term, this results in progressive, maladaptive cardiac remodeling and impairment of left ventricular function. This is thought to be a major contributor to increased cardiovascular mortality in end stage renal disease (ESRD). Medical strategies to acutely attenuate haemodynamic instability during HD are suboptimal...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29664034/incidence-prognosis-of-acute-kidney-injury-in-individuals-of-snakebite-in-a-tertiary-care-hospital-in-india
#8
Ramulu Pulimaddi, Amruth Rao Parveda, Balkishan Brahmanpally, Paul Marx Kalakanda, K Ramakrishna, Venkata Ramana Devi Chinnapaka
Background & objectives: The snakebites are considered to be an occupational hazard in agriculture workers and the snake handlers, resulting in a considerable morbidity, mortality and economical implications. This study was conducted to determine the incidence, clinical presentation, renal injury and clinical outcome in snakebite victims who developed acute kidney injury (AKI). Methods: This hospital-based prospective, observational study was done on 100 cases who were admitted for the management of snakebite and found to develop AKI in a tertiary care hospital at Hyderabad, India...
December 2017: Indian Journal of Medical Research
https://www.readbyqxmd.com/read/29644297/negative-pressure-in-treatment-of-persistent-post-traumatic-subcutaneous-emphysema-with-respiratory-failure-case-report-and-literature-review
#9
Jakov Mihanović, Ivan Bačić, Nina Sulen
Subcutaneous emphysema may aggravate traumatic pneumothorax treatment, especially when mechanical ventilation is required. Expectative management usually suffices, but when respiratory function is impaired surgical treatment might be indicated. Historically relevant methods are blowhole incisions and placement of various drains, often with related wound complications. Since the first report of negative pressure wound therapy for the treatment of severe subcutaneous emphysema in 2009, only few publications on use of commercially available sets were published...
February 2018: Trauma Case Reports
https://www.readbyqxmd.com/read/29642690/impella-protected-pci-the-clinical-results-achieved-so-far
#10
Gabriele Pesarini, Andrea Gratta, Giulia Dolci, Mattia Lunardi, Flavio L Ribichini
The ability of interventional cardiologists to identify high-risk percutaneous coronary interventions (PCI) patients, requires the integration of different features belonging to medical history, organ damage, coronary anatomy and the nature of the acute event. The selection of a subgroup of patients that could benefit from mechanical support during interventions is a key feature to success. The introduction of the Impella percutaneous axial pump have added an easy to set-up, less-invasive and time consuming active-support device to the interventional toolbox...
April 11, 2018: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/29597220/extra-renal-indications-for-continuous-renal-replacement-therapy
#11
Suvi T Vaara, Rinaldo Bellomo
Continuous renal replacement therapy (CRRT) has many potential indications that extend beyond the traditional removal of uremic waste products. Many of these stem from the capacity of CRRT to remove middle-sized molecules and its suitability for haemodynamically unstable patients. Using CRRT for immunomodulation to remove circulating plasma cytokines has created great enthusiasm and, in the past, immunomodulation was a frequently reported indication for commencing CRRT. Unfortunately, recent evidence from randomized controlled trials has been discouraging, and CRRT cannot be recommended for immunomodulation...
2018: Contributions to Nephrology
https://www.readbyqxmd.com/read/29578191/unenhanced-renal-magnetic-resonance-angiography-in-patients-with-chronic-kidney-disease-suspected-renovascular-hypertension-can-it-affect-patient-management
#12
J Yamuna, Anupama Chandrasekharan, Rajeswaran Rangasami, S Ramalakshmi, Santhosh Joseph
Background & objectives: Renal artery stenosis (RAS) is an important cause of severe hypertension in patients with chronic kidney disease (CKD). It is important to detect RAS early as it can reverse hypertension and stop rapid deterioration of renal function. The potential drawbacks of various imaging modalities used to detect RAS including contrast-related adverse effects associated with diagnostic angiography have led to increasing interest in unenhanced magnetic resonance (MR) renal angiography...
November 2017: Indian Journal of Medical Research
https://www.readbyqxmd.com/read/29572081/ldl-oxidation-serum-uric-acid-kidney-function-and-pulse-wave-velocity-data-from-the-brisighella-heart-study-cohort
#13
Arrigo F G Cicero, Masanari Kuwabara, Richard Johnson, Marilisa Bove, Federica Fogacci, Martina Rosticci, Marina Giovannini, Sergio D'Addato, Claudio Borghi
BACKGROUND: Serum uric acid (SUA) and oxidized LDL (oxLDL) may be associated with arterial aging. The aim of our study was to evaluate the relationship between SUA, oxLDL and arterial stiffness in subjects with normal renal function and in patients with mild or moderate renal impairment. METHODS: From the database of the 2012 Brisighella Heart Study, we compared age-matched adult, non-smoker subjects without cardiovascular disease and with normal renal function (n = 205), subjects with stage II chronic kidney disease (CKD) (n = 118) and subjects with stage III CKD (n = 94)...
June 15, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29544385/decrease-of-muscle-strength-in-vascular-access-hand-due-to-silent-ischaemia
#14
Tereza Kmentova, Anna Valerianova, Lucie Kovarova, Jana Lachmanova, Zuzana Hladinova, Jan Malik
BACKGROUND: Creation of vascular access leads to considerable local haemodynamic changes with decreased hand perfusion. Distal limb tissues then represent a model of hand ischaemia effect on muscles. The aim of our study was to investigate how the presence of vascular access influences the hand muscle strength in end-stage renal disease patients. METHODS: We included 52 chronically haemodialysed patients with upper limb access without clinical signs of hand ischaemia...
March 1, 2018: Journal of Vascular Access
https://www.readbyqxmd.com/read/29516300/defective-renal-autoregulation-in-the-chronic-bile-duct-ligation-model-of-liver-failure
#15
Tomchika Maoka, Tetsuya Kawata, Takao Koike, Toshio Mochizuki, Jurgen Schnermann, Seiji Hashimoto
BACKGROUND: Cirrhosis of the liver is often associated with an impairment of renal function that is usually not associated with consistent structural abnormalities of the renal parenchyma, but is thought to be the functional consequence of arterial underfilling and reduced arterial blood pressure. METHOD: We have used the cirrhosis model of chronic bile duct ligation (BDL) to assess the response of renal blood flow to a change of blood pressure. We have measured renal haemodynamics in BDL rats...
March 7, 2018: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/29514222/short-term-mechanical-circulatory-support-for-severe-primary-graft-dysfunction-following-orthotopic-heart-transplant
#16
Michal Hulman, Panagiotis Artemiou, Matej Ondrusek, Vladan Hudec, Ivo Gasparovic, Martin Bena, Ivan Glonek
OBJECTIVES: Primary graft dysfunction (PGD) is a devastating complication and the most common cause of early death following a heart transplant. The goal of this study was to report our experience of using mechanical circulatory support to manage severe PGD. METHODS: Following 208 heart transplants performed between January 2007 and May 2017, 14 (6.7%) patients presented with severe PGD. We provided haemodynamic support using the following approaches: a venoarterial extracorporeal membrane oxygenation device, left ventricular assist device, right ventricular assist device and biventricular assist device...
March 5, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29456043/colistin-alone-versus-colistin-plus-meropenem-for-treatment-of-severe-infections-caused-by-carbapenem-resistant-gram-negative-bacteria-an-open-label-randomised-controlled-trial
#17
Mical Paul, George L Daikos, Emanuele Durante-Mangoni, Dafna Yahav, Yehuda Carmeli, Yael Dishon Benattar, Anna Skiada, Roberto Andini, Noa Eliakim-Raz, Amir Nutman, Oren Zusman, Anastasia Antoniadou, Pia Clara Pafundi, Amos Adler, Yaakov Dickstein, Ioannis Pavleas, Rosa Zampino, Vered Daitch, Roni Bitterman, Hiba Zayyad, Fidi Koppel, Inbar Levi, Tanya Babich, Lena E Friberg, Johan W Mouton, Ursula Theuretzbacher, Leonard Leibovici
BACKGROUND: Colistin-carbapenem combinations are synergistic in vitro against carbapenem-resistant Gram-negative bacteria. We aimed to test whether combination therapy improves clinical outcomes for adults with infections caused by carbapenem-resistant or carbapenemase-producing Gram-negative bacteria. METHODS: A randomised controlled superiority trial was done in six hospitals in Israel, Greece, and Italy. We included adults with bacteraemia, ventilator-associated pneumonia, hospital-acquired pneumonia, or urosepsis caused by carbapenem-non-susceptible Gram-negative bacteria...
April 2018: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/29455174/bladder-necrosis-a-man-without-a-bladder
#18
Judith Bosschieter, Frederik H K Oudshoorn, Eric J H Meuleman, Jakko A Nieuwenhuijzen
Since the use of antibiotics, bladder necrosis has become a rare condition. We report a case of bladder necrosis in a 90-year-old man following urinary retention. After insertion of a transurethral catheter (TUC), 2 L of urine was evacuated. In the following days, the TUC became intermittently blocked. Adequate bladder drainage could not be obtained despite intensive rinsing and placement of a suprapubic catheter. On surgical exploration necrosis of almost the entire bladder wall, except for the trigone, was encountered...
February 17, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29454333/comparative-study-of-ultrasound-guided-paravertebral-block-versus-intravenous-tramadol-for-postoperative-pain-control-in-percutaneous-nephrolithotomy
#19
Zehra Hatipoglu, Ersel Gulec, Mediha Turktan, Volkan Izol, Atilla Arıdogan, Yasemin Gunes, Dilek Ozcengiz
BACKGROUND: Percutaneous nephrolithotomy (PCNL) is a minimally invasive surgical procedure for renal calculi, and nephrostomy tubes lead to postoperative pain after PCNL. Regional techniques (e.g., epidural analgesia and peripheral blocks) and opioids are applied for postoperative pain treatment. The aim of this study was to compare effectiveness of ultrasound-guided paravertebral block (PVB) and tramadol on postoperative pain in patients who underwent PCNL. METHOD: Fifty-three patients were included in this prospective randomized study...
February 17, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29438587/managing-penetrating-renal-trauma-experience-from-two-major-trauma-centres-in-the-uk
#20
Marios Hadjipavlou, Edmund Grouse, Robert Gray, Denosshan Sri, Dean Huang, Christian Brown, Davendra Sharma
OBJECTIVES: To present our series of patients with penetrating renal trauma treated at two urban major trauma centres and to discuss the contemporary management of such injuries. METHODS: We reviewed prospective urological trauma databases for all patients presenting with penetrating renal trauma between January 2005 and October 2016. Patient demographics, clinical characteristics, imaging, management and follow-up data were analysed. RESULTS: Over the 11-year period, 63 patients presented with penetrating renal injuries...
June 2018: BJU International
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