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https://www.readbyqxmd.com/read/29776826/recognition-of-sympathetic-crashing-acute-pulmonary-edema-scape-and-use-of-high-dose-nitroglycerin-infusion
#1
Samantha Paone, Leigha Clarkson, Billy Sin, Sheena Punnapuzha
Sympathetic Crashing Acute Pulmonary Edema (SCAPE), or flash pulmonary edema, is the extreme end of the acute pulmonary edema spectrum. A sympathetic surge occurs as a result of decreased systemic perfusion resulting in further increases in afterload, causing the patient to decompensate. Patients can decompensate quickly, therefore patients require rapid interventions. The use of high-dose nitroglycerin (HDN) has been a topic of interest as it is believed to achieve preload and afterload reduction. However, its use continues to be controversial due to concerns of drug induced hypotension, syncope or paresthesia...
May 10, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29768964/effects-of-combined-spinal-epidural-analgesia-on-first-stage-of-labor-a-cohort-study
#2
Silvia Poma, Luigia Scudeller, Chiara Verga, Giorgio Mirabile, Barbara Gardella, Federica Broglia, Maria Ciceri, Marinella Fuardo, Simona Pellicori, Maddalena Gerletti, Silvia Zizzi, Elena Masserini, Maria Paola Delmonte, Giorgio Antonio Iotti
BACKGROUND: Neuraxial anesthesia is considered as the gold standard in the control labor of pain. Its variants are epidural analgesia and combined spinal-epidural analgesia. Few studies, as yet, have investigated the duration of labor as a primary outcome. Some authors have suggested that combined spinal-epidural analgesia may reduce labor duration but at the moment the benefit of shortening labor is uncertain. The main aim of this study was to compare combined spinal-epidural with epidural analgesia in terms of their effect on duration of stage I labor, maternal, and neonatal outcomes...
May 17, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29764543/-experimental-research-on-individual-specific-rapid-potassium-supplementation-strategy-for-fatal-severe-hypokalemia
#3
Yu Du, Yi Mou, Jin Liu
OBJECTIVE: To explore the effectiveness and safety of the individual-specific rapid potassium supplementation strategy, and to provide experimental basis for treating fatal severe hypokalemia. METHODS: An acute fatal severe hypokalemia model was reproduced in 20 healthy adult Japanese big ear white rabbits with half lethal dose (LD50) of barium chloride (BaCl2 ) solution 168 mg×5 mL-1 ×kg-1 . The rabbits were divided into conventional potassium supplementation group and individual-specific rapid potassium supplementation group according to random number table method with 10 rabbits in each group...
May 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29760663/suppression-of-urinary-voiding-by-conditional-high-frequency-stimulation-of-the-pelvic-nerve-in-conscious-rats
#4
Charly B J Brouillard, Jonathan J Crook, Pedro P Irazoqui, Thelma A Lovick
Female Wistar rats were instrumented to record bladder pressure and to stimulate the left pelvic nerve. Repeated voids were induced by continuous infusion of saline into the bladder (11.2 ml/h) via a T-piece in the line to the bladder catheter. In each animal tested ( n = 6) high frequency pelvic nerve stimulation (1-3 kHz, 1-2 mA sinusoidal waveform for 60 s) applied within 2 s of the onset of a sharp rise in bladder pressure signaling an imminent void was able to inhibit micturition. Voiding was modulated in three ways: (1) Suppression of voiding (four rats, n = 13 trials)...
2018: Frontiers in Physiology
https://www.readbyqxmd.com/read/29757478/varying-the-rate-of-intravenous-cocaine-infusion-influences-the-temporal-dynamics-of-both-drug-and-dopamine-concentrations-in-the-striatum
#5
Ellie-Anna Minogianis, Waqqas M Shams, Omar S Mabrouk, Jenny-Marie T Wong, Wayne G Brake, Robert T Kennedy, Patrick du Souich, Anne-Noël Samaha
The faster drugs of abuse reach the brain, the greater is the risk of addiction. Even small differences in the rate of drug delivery can influence outcome. Infusing cocaine intravenously over 5 versus 90-100 seconds promotes sensitization to the psychomotor and incentive motivational effects of the drug and preferentially recruits mesocorticolimbic regions. It remains unclear whether these effects are due to differences in how fast and/or how much drug reaches the brain. Here, we predicted that varying the rate of intravenous cocaine infusion between 5-90 seconds produces different rates of rise of brain drug concentrations, while producing similar peak concentrations...
May 14, 2018: European Journal of Neuroscience
https://www.readbyqxmd.com/read/29754771/epstein-barr-virus-specific-cytokine-induced-killer-cells-for-treatment-of-epstein-barr-virus-related-malignant-lymphoma
#6
Lisa-Marie Pfeffermann, Verena Pfirrmann, Sabine Huenecke, Melanie Bremm, Halvard Bonig, Hans-Michael Kvasnicka, Thomas Klingebiel, Peter Bader, Eva Rettinger
BACKGROUND: Prolonged immunosuppression or delayed T-cell recovery may favor Epstein-Barr virus (EBV) infection or reactivation after allogeneic hematopoietic stem cell transplantation (HSCT), which can lead to post-transplant lymphoproliferative disease (PTLD) and high-grade malignant B-cell lymphoma. Cytokine-induced killer (CIK) cells with dual specific anti-tumor and virus-specific cellular immunity may be applied in this context. METHODS: CIK cells with EBV-specificity were generated from peripheral blood mononuclear cells (PBMCs), expanded in the presence of interferon-γ, anti-CD3, interleukin (IL)-2 and IL-15 and were pulsed twice with EBV consensus peptide pool...
May 10, 2018: Cytotherapy
https://www.readbyqxmd.com/read/29748628/7t-1-h-mrs-in-major-depressive-disorder-a-ketamine-treatment-study
#7
Jennifer W Evans, Níall Lally, Li An, Ningzhi Li, Allison C Nugent, Dipavo Banerjee, Sam L Snider, Jun Shen, Jonathan P Roiser, Carlos A Zarate
The glutamatergic modulator ketamine has striking and rapid antidepressant effects in major depressive disorder (MDD), but its mechanism of action remains unknown. Proton magnetic resonance spectroscopy (1H-MRS) is the only non-invasive method able to directly measure glutamate levels in vivo; in particular, glutamate and glutamine metabolite concentrations are separable by 1H-MRS at 7T. This double-blind, placebo-controlled, crossover study that included 1 H-MRS scans at baseline and at 24 h post ketamine and post-placebo infusions sought to determine glutamate levels in the pregenual anterior cingulate (pgACC) of 20 medication-free MDD subjects and 17 healthy volunteers (HVs) 24 h post ketamine administration, and to evaluate any other measured metabolite changes, correlates, or predictors of antidepressant response...
April 5, 2018: Neuropsychopharmacology: Official Publication of the American College of Neuropsychopharmacology
https://www.readbyqxmd.com/read/29743313/ivig-promote-cross-tolerance-against-inflammatory-stimuli-in-vitro-and-in-vivo
#8
Ángeles Domínguez-Soto, Miriam Simón-Fuentes, Mateo de Las Casas-Engel, Víctor D Cuevas, María López-Bravo, Jorge Domínguez-Andrés, Paula Saz-Leal, David Sancho, Carlos Ardavín, Juliana Ochoa-Grullón, Silvia Sánchez-Ramón, Miguel A Vega, Angel L Corbí
IVIg is an approved therapy for immunodeficiency and for several autoimmune and inflammatory diseases. However, the molecular basis for the IVIg anti-inflammatory activity remains to be fully explained and cannot be extrapolated from studies on animal models of disease. We now report that IVIg impairs the generation of human monocyte-derived anti-inflammatory macrophages by inducing JNK activation and activin A production and limits proinflammatory macrophage differentiation by inhibiting GM-CSF-driven STAT5 activation...
May 9, 2018: Journal of Immunology: Official Journal of the American Association of Immunologists
https://www.readbyqxmd.com/read/29732161/rapid-onset-diabetic-ketoacidosis-secondary-to-nivolumab-therapy
#9
Senhong Lee, Aparna Morgan, Sonali Shah, Peter R Ebeling
We report a case of a 67-year-old man with type 2 diabetes presented with diabetic ketoacidosis, two weeks after his first dose of nivolumab therapy for non-small-cell lung carcinoma. He was started on empagliflozin two days prior in the setting of hyperglycaemia after the initiation of nivolumab therapy. Laboratory evaluation revealed an undetectable C-peptide and a positive anti-glutamic acid decarboxylase (GAD) antibody. He was treated with intravenous fluids and insulin infusion and was subsequently transitioned to subcutaneous insulin and discharged home...
2018: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/29727073/efficacy-safety-and-durability-of-repeated-ketamine-infusions-for-comorbid-posttraumatic-stress-disorder-and-treatment-resistant-depression
#10
C Sophia Albott, Kelvin O Lim, Miriam K Forbes, Christopher Erbes, Susanna J Tye, John G Grabowski, Paul Thuras, Tegan M Batres-Y-Carr, Joseph Wels, Paulo R Shiroma
OBJECTIVE: The present study examined the efficacy, safety, and durability of repeated ketamine infusions for the treatment of comorbid posttraumatic stress disorder (PTSD) and treatment-resistant depression (TRD) in a sample of veterans. METHODS: Individuals with comorbid DSM-5-defined PTSD and DSM-IV-defined major depressive disorder (N = 15) received 6 intravenous ketamine infusions (0.5 mg/kg) on a Monday-Wednesday-Friday schedule over a 12-day period from May 2015 to June 2016...
May 1, 2018: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/29724899/the-dot1l-inhibitor-pinometostat-reduces-h3k79-methylation-and-has-modest-clinical-activity-in-adult-acute-leukemia
#11
Eytan M Stein, Guillermo Garcia-Manero, David A Rizzieri, Raoul Tibes, Jesus G Berdeja, Michael R Savona, Mojca Jongen-Lavrenic, Jessica K Altman, Blythe Thomson, Stephen J Blakemore, Scott R Daigle, Nigel J Waters, A Benjamin Suttle, Alicia Clawson, Roy Pollock, Andrei Krivtsov, Scott A Armstrong, Jorge DiMartino, Eric Hedrick, Bob Löwenberg, Martin S Tallman
Pinometostat (EPZ-5676) is a first-in-class, small-molecule inhibitor of the histone methyltransferase DOT1L. In this phase 1 study, pinometostat was evaluated for safety and efficacy in adult patients with advanced acute leukemias, particularly those involving MLL rearrangements ( MLL-r ) resulting from 11q23 translocations. Fifty-one patients were enrolled into 6 dose escalation cohorts (n=26) and 2 expansion cohorts (n=25) at pinometostat doses of 54 and 90 mg/m2 /day by continuous intravenous infusion in 28-day cycles...
May 3, 2018: Blood
https://www.readbyqxmd.com/read/29724318/-safety-of-a-60-minute-rituximab-rapid-infusion-protocol-for-adult-b-cell-lymphoma-patients-a-single-center-single-arm-clinical-trail
#12
Shuang Jiao Liu, Wei Meng, Yan Bin Zhang
Objective To investigate the safety of a 60-minute rituximab rapid infusion protocol in the maintenance therapy for Chinese B-cell lymphoma patients (including the elderly) and to discuss the feasibility of rituximab treatment in outpatient departments or daily wards. Methods This prospective study enrolled 820 patients diagnosed with B cell lymphoma in the Department of Hematology of Peking Union Medical College Hospital from February 2015 to July 2016. From the second chemotherapy cycle,rituximab was infused within 60 minutes (100 mg/h over the first 15 minutes and the remaining dose given over 45 minutes, there was no maximum infusion rate,and 700 mg/h was acceptable),and the adverse reactions were recorded...
April 28, 2018: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
https://www.readbyqxmd.com/read/29713969/rituximab-for-refractory-rapidly-progressive-interstitial-lung-disease-related-to-anti-mda5-antibody-positive-amyopathic-dermatomyositis
#13
Ho So, Victor Tak Lung Wong, Virginia Weng Nga Lao, Hin Ting Pang, Ronald Man Lung Yip
To report our experience in using rituximab (RTX) for treating refractory rapidly progressive interstitial lung disease (RP-ILD) complicating anti-melanoma differentiation-associated gene 5 antibody (anti-MDA5 Ab)-positive amyopathic dermatomyositis (ADM). Medical records of four ADM patients with refractory RP-ILD treated with RTX therapy were reviewed retrospectively. All four patients were tested positive for anti-MDA5 Ab and failed to respond to high-dose systemic steroid and other intensive immunosuppressive therapies...
April 30, 2018: Clinical Rheumatology
https://www.readbyqxmd.com/read/29709945/a-case-of-fulminant-type-1-diabetes-mellitus-complicated-with-a-life-threatening-electrolyte-abnormality-and-abnormal-electrocardiogram-findings
#14
Tomoe Kinoshita, Hideaki Kaneto, Fumiko Kawasaki, Takatoshi Anno, Takeyuki Kurihara, Haruki Yamada, Yoshiyuki Oshiro, Naoyuki Miyashita, Niro Okimoto, Kohei Kaku
Fulminant type 1 diabetes mellitus (T1DM) is idiopathic T1DM with the rapid destruction of pancreatic β-cells. We herein report a 48-year-old man who developed fulminant T1DM complicated with a life-threatening electrolyte abnormality and abnormal electrocardiogram findings. He had no remarkable medical history, but one day, he developed general fatigue. His blood glucose level and HbA1c were 806 mg/dL and 6.3%, and his insulin secretion was markedly suppressed. He had ketoacidosis, hyponatremia and hyperkalemia...
April 27, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29709420/outcome-of-patients-with-cardiac-amyloidosis-admitted-to-an-intensive-care-unit-for-acute-heart-failure
#15
Thomas d'Humières, Damien Fard, Thibaud Damy, Francois Roubille, Arnaud Galat, Huy-Long Doan, Leopold Oliver, Jean-Luc Dubois-Randé, Pierre Squara, Pascal Lim, Julien Ternacle
BACKGROUND: The outcome of cardiac amyloidosis (CA) has been reported mainly in stable populations; limited data are available in patients referred for acute heart failure (AHF) to an intensive cardiac care unit (ICCU). AIMS: To address the characteristics and outcomes of patients with confirmed CA admitted to an ICCU for AHF and then to identify the predictors of evolution to cardiogenic shock. METHODS: All patients with CA referred to an ICCU for AHF between 2009 and 2015 were included...
April 27, 2018: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/29705790/immunotherapy-of-hepatocellular-carcinoma
#16
Bernd Heinrich, Carolin Czauderna, Jens U Marquardt
Hepatocellular carcinoma (HCC) is one of the most deadly and rapidly evolving cancers worldwide. The current systemic treatment strategies in advanced tumor stages remain limited despite promising preclinical and early-phase clinical results for some compounds, highlighting an unmet clinical need. Since the majority of HCCs evolve in the background of a chronic inflammatory liver damage, HCCs can be considered a paradigm for inflammation-induced cancers, which renders immunotherapeutic strategies particularly promising for this tumor entity...
2018: Oncology Research and Treatment
https://www.readbyqxmd.com/read/29701417/surgical-thrombectomy-fibrinolysis-angioplasty-and-stenting-a-combined-approach-for-treatment-of-a-may-thurner-syndrome-presenting-as-phlegmasia-cerulea-dolens
#17
Carlos Veiga, João Gonçalves, Pedro Sousa, Carolina Vaz, Ivone Silva, Pedro Sá-Pinto, Rui Almeida
INTRODUCTION: Phlegmasia cerulea dolens (PCD) is a rare complication of deep venous thrombosis (DVT). Massive ileo-femoral DVT is usually the cause and prompt treatment is mandatory as it represents a medical emergency. Reported amputation rates range from 12% to 25% and mortality ranges from 25% to 40%. Limb ischemia results from obstruction to arterial inflow secondary to extreme levels of venous hypertension. Primary treatment goal is restoration of venous outflow and can be achieved by endovascular or surgical techniques...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29693947/use-of-sugammadex-in-a-patient-with-myotonic-dystrophy-undergoing-laparoscopic-cholecystectomy
#18
Rieko Uno, Shoko Matsuda, Kohei Murao, Kumiko Nakamura, Michiyo Shirakawa, Koh Shingu
A 37-year-old female patient with myotonic dystrophy was scheduled for laparoscopic cholecystectomy for gall stone under general anesthesia with continuous propofol infusion. Rocuronium was administered with careful monitoring using TOF- Watch®, measuring train-of-four count (Tc), TOF ratio (Tr), and posttetanic count The total amount of rocuronium was 70 mg ; 0.6 mg .kg⁻1 for anesthetic induction and 0.3 mg .kg⁻1 when Tc exceeded 1. When the operation was completed, Tc was 4, Tr was uncountable and she showed reaction to calling her name...
May 2017: Masui. the Japanese Journal of Anesthesiology
https://www.readbyqxmd.com/read/29693946/a-case-of-sudden-shock-during-caesarean-section-in-whi-ch-amniotic-fluid-embolism-is-suspected
#19
Hiroo Shimono, Satoko Haraguchi, Yuko Minoda, Mari Beppu, Naomi Shinmura, Yuki Suzuki, Mikiko Higashi, Yuichi Kanmura
We report a case of sudden shock during caesarean section under combined spinal epidural anesthesia. The patient was a 29-year-old woman. During the operation vital signs had been almost stable until a female-baby was born. But after the delivery of the placenta, the patient developed an episode of coughing and dyspnea followed by unconsciousness and bradycardia. She was given adrenaline and intubated, appearing ventricular fibrillation on a EKG. Cardiopulmonary resuscitation was immediately started and sinus rhythm returned...
May 2017: Masui. the Japanese Journal of Anesthesiology
https://www.readbyqxmd.com/read/29693944/unexpected-systolic-anterior-motion-of-the-mitral-valve-diagnosed-by-transthoracic-echocardiography-after-the-induction-of-general-anesthesia
#20
Toshiyuki Nakanishi, Manabu Yoshimura, Seishi Sakamoto, Takashi Toriumi
We report an 87-year-old woman who presented with unexpected systolic anterior motion (SAM) of the mitral valve after the induction of general anesthesia. She was receiving medication for hypertension and cerebral infarction. There were no abnormal findings on her preoperative transthoracic echocardiography (TTE) examination. After the induction of general anesthesia, she presented with refractory hypotension. We performed TTE and diagnosed SAM of the mitral valve. Her hemodynamic state was improved by fluid infusion and administering intravenous phenylephrine...
May 2017: Masui. the Japanese Journal of Anesthesiology
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