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Fluid overload

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https://www.readbyqxmd.com/read/29150999/focus-on-focus-lack-of-coherence-between-systemic-and-microvascular-indices-of-edema-formation
#1
Birkitt Ten Tusscher, Corien Gudden, Suus van Vliet, Bob Smit, Can Ince, E Christiaan Boerma, Harm-Jan S de Grooth, Paul W G Elbers
BACKGROUND: Fluid therapy remains a cornerstone of therapy in shock states. However, fluid overloading ultimately results in edema formation which is related to excess morbidity and mortality. Handheld microscopes are now frequently used to study the sublingual microcirculation. As a corollary, these devices measure focal distance, or surface to capillary distance. Physiologically, this could represent a microvascular index of edema formation and could have the potential to guide fluid therapy...
November 18, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29150301/is-subchondral-bone-cyst-formation-in-non-load-bearing-region-of-osteoarthritic-knee-a-vascular-problem
#2
Pok Man Boris Chan, Chunyi Wen, Wai Ching Yang, Chunhoi Yan, KwongYuen Chiu
Subchondral bone cyst is common in the progressive knee osteoarthritis yet its underlying mechanism remains unclear. In addition to the existing theories such as synovial fluid influx and mechanical contusion, we identified the potential link between vascular pathology and osteoarthritic bone pathologies including cystic lesion formation, particularly in the non-load-bearing region. This new hypothesis for SBC formation in non-load-bearing region for knee, which cannot be explained by the existing theories, will provide us a new angle to understand the pathomechanism and pathophysiology of subchondral bone disturbance in osteoarthritis in addition to the classical biomechanical overloading theories...
November 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/29147843/iron-and-infection
#3
REVIEW
Tomas Ganz
Iron is an essential trace metal for nearly all infectious microorganisms, and host defense mechanisms target this dependence to deprive microbes of iron. This review highlights mechanisms that are activated during infections to restrict iron on mucosal surfaces, in plasma and extracellular fluid, and within macrophages. Iron overload disorders, such as hereditary hemochromatosis or β-thalassemia, interfere with iron-restrictive host responses, and thereby cause increased susceptibility to infections with microbes that can exploit this vulnerability...
November 16, 2017: International Journal of Hematology
https://www.readbyqxmd.com/read/29142540/clinical-audit-of-dengue-related-deaths-in-2011-mayo-hospital-lahore-pakistan
#4
Somia Iqtadar, Nabeel Akbar, Mehreen Mehmood, Sajid Abaidullah
Background and Objective: Dengue infection has evolved into an epidemic during last few years in Pakistan and has been associated with poor outcomes. Literature with respect to mortality risk factors in Dengue infection is not sufficient. This compelled us to conduct this study to find out major contributory factors to death in patients with dengue viral infection at one of Asia's ancient hospital setting with an aim to recognize complications at earliest and improve case management in future...
September 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/29132737/discordance-between-bioelectrical-impedance-vector-analysis-and-the-new-espen-definition-of-malnutrition-for-the-diagnosis-of-hospital-malnutrition
#5
Edgar Dehesa-López, Jesús Israel Martínez-Felix, Arturo Ruiz-Ramos, Ximena Atilano-Carsi
BACKGROUND & AIMS: No universally accepted diagnostic criteria for malnutrition are available to date. The aim was to assess the concordance for the diagnosis of hospital malnutrition between the bioelectrical impedance vector analysis (BIVA) and the new definition of malnutrition proposed by the European Society for Clinical Nutrition and Metabolism (ESPEN). METHODS: A total of 140 adult hospitalized patients were included. The malnutrition risk was assessed by the Nutritional Risk Screening...
April 2017: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/29129410/iron-metabolism-and-the-role-of-the-iron-regulating-hormone-hepcidin-in-health-and-disease
#6
Raed Daher, Hana Manceau, Zoubida Karim
Although iron is vital, its free form is likely to be involved in oxidation-reduction reactions, leading to the formation of free radicals and oxidative stress. Living organisms have developed protein systems to transport free iron through the cell membranes and biological fluids and store it in a non-toxic and readily mobilizable form to avoid iron toxicity. Hepcidin plays a crucial role in maintaining iron homeostasis. Hepcidin expression is directly regulated by variations in iron intake and its repression leads to an increase in bioavailable serum iron level...
November 9, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/29128923/fluid-overload-independent-of-acute-kidney-injury-predicts-poor-outcomes-in-neonates-following-congenital-heart-surgery
#7
Kenneth E Mah, Shiying Hao, Scott M Sutherland, David M Kwiatkowski, David M Axelrod, Christopher S Almond, Catherine D Krawczeski, Andrew Y Shin
BACKGROUND: Fluid overload (FO) is common after neonatal congenital heart surgery and may contribute to mortality and morbidity. It is unclear if the effects of FO are independent of acute kidney injury (AKI). METHODS: This was a retrospective cohort study which examined neonates (age < 30 days) who underwent cardiopulmonary bypass in a university-affiliated children's hospital between 20 October 2010 and 31 December 2012. Demographic information, risk adjustment for congenital heart surgery score, surgery type, cardiopulmonary bypass time, cross-clamp time, and vasoactive inotrope score were recorded...
November 11, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/29127125/vancomycin-resistant-enterococcus-faecium-bacteraemia-as-a-complication-of-kayexalate-sodium-polystyrene-sulfonate-sps-in-sorbitol-induced-ischaemic-colitis
#8
Roberto Christian Cerrud-Rodriguez, Diego Alcaraz-Alvarez, Brian Bobby Chiong, Abdurhman Ahmed
We present the case report of an 80-year-old woman with chronic kidney disease stage G5 admitted to the hospital with fluid overload and hyperkalaemia. Sodium polystyrene sulfonate (SPS, Kayexalate) in sorbitol suspension was given orally to treat her hyperkalaemia, which precipitated an episode of SPS in sorbitol-induced ischaemic colitis with the subsequent complication of vancomycin-resistant Enterococcus (VRE) bacteraemia. SPS (Kayexalate) in sorbitol suspension has been implicated in the development of intestinal necrosis...
November 9, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29123557/defining-fluid-removal-in-the-intensive-care-unit-a-national-and-international-survey-of-critical-care-practice
#9
Michael E O'Connor, Sarah L Jones, Neil J Glassford, Rinaldo Bellomo, John R Prowle
Design and objectives: To identify and compare how intensive care unit specialists in the United Kingdom and Australia and New Zealand self-reportedly define, assess and manage fluid overload in critically ill patients using a structured online questionnaire. Results: We assessed 219 responses. Australia and New Zealand and United Kingdom intensive care unit specialists reported using clinical examination findings, bedside tools and radiological features to assess fluid status, diagnose fluid overload and initiate fluid removal in the critically ill...
November 2017: J Intensive Care Soc
https://www.readbyqxmd.com/read/29112081/predictors-prevalence-and-outcomes-of-early-crystalloid-responsiveness-among-initially-hypotensive-patients-with-sepsis-and-septic-shock
#10
Daniel E Leisman, Martin E Doerfler, Sandra M Schneider, Kevin D Masick, Jason A D'Amore, John K D'Angelo
OBJECTIVES: The prevalence of responsiveness to initial fluid challenge among hypotensive sepsis patients is unclear. To avoid fluid overload, and unnecessary treatment, it is important to differentiate these phenotypes. We aimed to 1) determine the proportion of hypotensive sepsis patients sustaining favorable hemodynamic response after initial fluid challenge, 2) determine demographic and clinical risk factors that predicted refractory hypotension, and 3) assess the association between timeliness of fluid resuscitation and refractoriness...
November 3, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29109947/acute-exacerbation-in-interstitial-lung-disease
#11
REVIEW
Gabriela Leuschner, Jürgen Behr
Acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF) has been defined as an acute, clinically significant deterioration that develops within less than 1 month without obvious clinical cause like fluid overload, left heart failure, or pulmonary embolism. Pathophysiologically, damage of the alveoli is the predominant feature of AE-IPF which manifests histopathologically as diffuse alveolar damage and radiologically as diffuse, bilateral ground-glass opacification on high-resolution computed tomography...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/29100540/isolated-right-ventricular-thrombus-in-an-adult-patient-with-nephrotic-syndrome-a-case-report
#12
Severin Lempp, Vedat Schwenger
BACKGROUND: Venous thrombosis in nephrotic syndrome is a well-described phenomenon. We report a case of an adult patient with an isolated thrombus in the right ventricle due to nephrotic syndrome, which was initially suspected to be a myxoma. CASE PRESENTATION: A 28-year-old white woman presented to our emergency department with signs of fluid overload. On further evaluation, a right ventricular mass was detected, which was resected and was found to be a thrombus...
November 4, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29095000/the-effects-of-a-low-carbohydrate-diet-on-oxygen-saturation-in-heart-failure-patients-a-randomized-controlled-clinical-trial
#13
Dulce González-Islas, Arturo Orea-Tejeda, Lilia Castillo-Martínez, Gabriela Olvera-Mayorga, Wendy Daniella Rodríguez-García, Cira Santillán-Díaz, Candace Keirnes-Davis, Nayeli Vaquero-Barbosa
INTRODUCTION: Nutritional therapy in heart failure (HF) patients has been focused on fluid and sodium restriction with the aim of decreasing volume overload. However, these recommendations are not well established and sometimes controversial. OBJECTIVE: To evaluate the effect of the consumption of a low-carbohydrate diet on oxygen saturation, body composition and clinical variables during two months of follow-up in chronic, stable heart failure patients. METHODS: In a parallel group randomized controlled clinical trial, 88 ambulatory patients were randomly assigned to a low-carbohydrate diet group (40% carbohydrates, 20% protein and 40% fats [12% saturated, 18% monounsaturated and 10% polyunsaturated]) or a standard diet group (50% carbohydrates, 20% protein and 30% fats [10% saturated, 10% monounsaturated and 10% polyunsaturated]) for two months...
July 28, 2017: Nutrición Hospitalaria: Organo Oficial de la Sociedad Española de Nutrición Parenteral y Enteral
https://www.readbyqxmd.com/read/29068910/neutrophil-phenotype-correlates-with-postoperative-inflammatory-outcomes-in-infants-undergoing-cardiopulmonary-bypass
#14
Jody N Huber, Brieanna M Hilkin, Jessica S Hook, Patrick D Brophy, Tina L Davenport, James E Davis, Tarah T Colaizy, Jessica G Moreland
OBJECTIVES: Infants with congenital heart disease frequently require cardiopulmonary bypass, which causes systemic inflammation. The goal of this study was to determine if neutrophil phenotype and activation status predicts the development of inflammatory complications following cardiopulmonary bypass. DESIGN: Prospective cohort study. SETTING: Tertiary care PICU with postoperative cardiac care. PATIENTS: Thirty-seven patients 5 days to 10 months old with congenital heart disease requiring cardiopulmonary bypass...
October 24, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29058354/the-practice-of-diagnosing-and-reporting-transfusion-associated-circulatory-overload-a-national-survey-among-physicians-and-haemovigilance-officers
#15
J J Bosboom, R B Klanderman, A L Peters, E K van de Weerdt, E J Goudswaard, J M Binnekade, J J Zwaginga, E A M Beckers, B F Geerts, M W Hollmann, S S Zeerleder, M van Kraaij, A P Vlaar
OBJECTIVES: This study aims at identifying factors that disciplines consider when diagnosing and reporting transfusion-associated circulatory overload ('TACO'). BACKGROUND: TACO is a clinical diagnosis based mainly on subjective factors. Therefore, TACO could be an underreported complication of blood transfusion. METHODS: A survey was conducted among critical care physicians, anaesthesiologists, haematologists, transfusion medicine physicians and haemovigilance officers using case vignettes and a questionnaire...
October 23, 2017: Transfusion Medicine
https://www.readbyqxmd.com/read/29052790/efficacy-and-safety-of-glecaprevir-pibrentasvir-in-hcv-infected-japanese-patients-with-prior-daa-experience-severe-renal-impairment-or-genotype-3-infection
#16
Hiromitsu Kumada, Tsunamasa Watanabe, Fumitaka Suzuki, Kenji Ikeda, Ken Sato, Hidenori Toyoda, Masanori Atsukawa, Akio Ido, Akinobu Takaki, Nobuyuki Enomoto, Koji Kato, Katia Alves, Margaret Burroughs, Rebecca Redman, David Pugatch, Tami J Pilot-Matias, Preethi Krishnan, Rajneet K Oberoi, Wangang Xie, Kazuaki Chayama
BACKGROUND: Once-daily, orally administered, co-formulated glecaprevir (NS3/4A protease inhibitor) and pibrentasvir (NS5A inhibitor) (G/P) demonstrated pangenotypic activity and high sustained virologic response (SVR) rates in studies outside Japan. Here we report safety and efficacy in a subset of Japanese patients with chronic HCV infection who received G/P 300/120 mg in a phase 3, open-label, multicenter study (CERTAIN-1). METHODS: This analysis focuses on three difficult-to-treat subgroups: HCV GT1/2-infected patients who failed to achieve SVR after treatment with a direct acting antiviral (DAA)-containing regimen; GT1/2-infected patients with severe renal impairment (estimated glomerular filtration rate < 30 mL/min/1...
October 20, 2017: Journal of Gastroenterology
https://www.readbyqxmd.com/read/29047069/postoperative-visceral-tissue-edema-assessed-by-computed-tomography-is-a-predictor-for-severe-complications-after-pancreaticoduodenectomy
#17
Atsushi Shimizu, Manabu Kawai, Seiko Hirono, Ken-Ichi Okada, Motoki Miyazawa, Yuji Kitahata, Masaki Ueno, Shinya Hayami, Atsushi Miyamoto, Yoshiki Kimoto, Toshio Shimokawa, Hiroki Yamaue
BACKGROUND/AIMS: In pancreatoduodenectomy (PD), the adverse impact of tissue edema owing to intraoperative fluid overload remains unclear. This study aims to evaluate how visceral tissue edema due to fluid overload affects severe postoperative complications after PD. It aims to clarify the usefulness of assessment by computed tomography (CT) of postoperative tissue edema. METHODS: We classified 200 patients who underwent PD as either liberal fluid management (LFM) group (n = 100) or goal-directed fluid therapy (GDFT) group (n = 100), based on intraoperative fluid management...
October 18, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29044493/combining-echo-and-natriuretic-peptides-to-guide-heart-failure-care-in-the-outpatient-setting-a-position-paper
#18
REVIEW
Frank Lloyd Dini, Erberto Carluccio, Fabrizio Montecucco, Gian Marco Rosa, Paolo Fontanive
BACKGROUND: Chronic heart failure (HF) is a relevant and growing public health problem. Although the prognosis has recently improved, it remains a lethal disease, with a mortality that equals or exceeds that of many malignancies. Furthermore, chronic HF is costly, representing a large and growing drain on healthcare resources. METHODS: This narrative review is based on the material searched for and obtained via PubMed up to May 2017. The search terms we used were: "heart failure, echocardiography, natriuretic peptides" in combination with "treatment, biomarkers, guidelines"...
October 16, 2017: European Journal of Clinical Investigation
https://www.readbyqxmd.com/read/29038040/hysteroscopic-intrauterine-adhesiolysis-using-a-blunt-spreading-dissection-technique-with-a-double-action-forceps
#19
Huan Huang, Chunxia Cheng, Grace Johnson, Ruoyi Wang, Min Xue, Aiqian Zhang, Dabao Xu, Xiaoming Guan
STUDY OBJECTIVE: To demonstrate step by step the technique of hysteroscopic adhesiolysis (HA) by means of a blunt spreading technique using double action forceps to dissect and restore the layer between the anterior and posterior uterine walls in a patient with severe intrauterine adhesions (IUA), particularly in cases in which the endometrial lining is obscured on ultrasound imaging and the endometrial cavity is completely occluded on hysteroscopy. DESIGN: Step-by-step explanation of the technique using videos and pictures (educative video) (Canadian Task Force Classification III)...
October 13, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29028633/acute-kidney-injury-in-congenital-heart-disease
#20
Katja M Gist, David M Kwiatkowski, David S Cooper
PURPOSE OF REVIEW: Acute kidney injury (AKI) is associated with significant morbidity and mortality in patients with congenital heart disease undergoing cardiac surgery or in pediatric patients with congestive heart failure. RECENT FINDINGS: This review describes the definition and various manifestations of AKI, the impact of biomarkers on the diagnosis of AKI, the importance of fluid overload as a consequence of AKI and its long-term impact. SUMMARY: There are novel biomarkers for AKI detection that should facilitate early recognition and intervention to prevent or attenuate the effects of AKI and fluid overload...
October 11, 2017: Current Opinion in Cardiology
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