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Marije Smit, Maureen J M Werner, Annemieke Oude Lansink-Hartgring, Willem Dieperink, Jan G Zijlstra, Matijs van Meurs
BACKGROUND: Intra-abdominal hypertension (IAH) is frequently present in critically ill patients and is an independent predictor for mortality. Better recognition of clinically important thresholds is necessary. Increased intra-abdominal pressure (IAP) is associated with renal dysfunction, and renal failure is one of the most consistently described organ dysfunctions associated with IAH. Obesity is also associated with kidney injury. The underlying mechanisms are not yet fully understood...
December 2016: Annals of Intensive Care
M C O van IJzendoorn, H Buter, W P Kingma, G J Navis, E C Boerma
Background. ICU acquired hypernatremia (IAH, serum sodium concentration (sNa) ≥ 143 mmol/L) is mainly considered iatrogenic, induced by sodium overload and water deficit. Main goal of the current paper was to answer the following questions: Can the development of IAH indeed be explained by sodium intake and water balance? Or can it be explained by renal cation excretion? Methods. Two retrospective studies were conducted: a balance study in 97 ICU patients with and without IAH and a survey on renal cation excretion in 115 patients with IAH...
2016: Critical Care Research and Practice
Gianna Camiciottoli, Francesca Bigazzi, Chiara Magni, Viola Bonti, Stefano Diciotti, Maurizio Bartolucci, Mario Mascalchi, Massimo Pistolesi
BACKGROUND: In addition to lung involvement, several other diseases and syndromes coexist in patients with chronic obstructive pulmonary disease (COPD). Our purpose was to investigate the prevalence of idiopathic arterial hypertension (IAH), ischemic heart disease, heart failure, peripheral vascular disease (PVD), diabetes, osteoporosis, and anxious depressive syndrome in a clinical setting of COPD outpatients whose phenotypes (predominant airway disease and predominant emphysema) and severity (mild and severe diseases) were determined by clinical and functional parameters...
2016: International Journal of Chronic Obstructive Pulmonary Disease
Hua-Yu Zhang, Dong Liu, Hao Tang, Shi-Jin Sun, Shan-Mu Ai, Wen-Qun Yang, Dong-Po Jiang, Lian-Yang Zhang
BACKGROUND: Intra-abdominal hypertension (IAH) is a disease with high morbidity and mortality among critically ill patients. The study's objectives were to explore the prevalence of IAH and physicians' awareness of the 2013 World Society of Abdominal Compartment Syndrome (WSACS) guidelines in Chinese intensive care units (ICUs). METHODS: A cross-sectional study of four ICUs in Southwestern China was conducted from June 17 to August 2, 2014. Adult patients admitted to the ICU for more than 24 h, with bladder catheter but without obvious intravesical pressure (IVP) measurement contraindications, were recruited...
2016: Military Medical Research
Michael A Mazzeffi, Patrick Stafford, Karin Wallace, Wendy Bernstein, Seema Deshpande, Patrick Odonkor, Ashanpreet Grewal, Erik Strauss, Latoya Stubbs, James Gammie, Peter Rock
OBJECTIVE: To determine the incidence of intra-abdominal hypertension (IAH) in adult cardiac surgery patients and its association with postoperative kidney dysfunction. DESIGN: Prospective cohort study. SETTING: Single tertiary-care university hospital. PARTICIPANTS: Forty-two adult patients having cardiac surgery with cardiopulmonary bypass. INTERVENTIONS: Intra-abdominal pressure (IAP) was measured preoperatively, immediately after surgery, and at the following time points after surgery: 3 hours, 6 hours, 12 hours, and 24 hours...
May 19, 2016: Journal of Cardiothoracic and Vascular Anesthesia
Mingtao Chang, Hao Tang, Dong Liu, Yang Li, Lianyang Zhang
A variety of agents may have a beneficial effect in reducing injury-induced intestinal edema of fluid, but studies confirming the efficacy and mechanisms of these agents in secondary intra-abdominal hypertension (IAH) are lacking. This study was to compare the effectiveness of melatonin, 7.5% hypertonic saline (HS), and hydroxyethyl starch 130/0.4 (HES) on the resuscitation of secondary IAH in a rat model. Female SD rats were divided into: sham group, shock group, lactated Ringer solution (LR) group, melatonin group, HS group, and HES group...
2016: PloS One
Andrew Huff, Toph Allen, Karissa Whiting, Nathan Breit, Brock Arnold
INTRODUCTION:  Beginning in 2015, Zika virus rapidly spread throughout the Americas and has been linked to neurological and autoimmune diseases in adults and babies. Developing accurate tools to anticipate Zika spread is one of the first steps to mitigate further spread of the disease. When combined, air traffic data and network simulations can be used to create tools to predict where infectious disease may spread to and aid in the prevention of infectious diseases. Specific goals were to: 1) predict where travelers infected with the Zika Virus would arrive in the U...
2016: PLoS Currents
Mingtao Chang, Yang Li, Dong Liu, Lianyang Zhang, Hongguang Zhang, Hao Tang, Huayu Zhang
Exogenous administration of melatonin has been demonstrated to down-regulate inflammatory responses and attenuate organ damage in various models. However, the salutary effect of melatonin against secondary intra-abdominal hypertension (IAH) remains unclear. This study sought to test the influence of melatonin on secondary IAH in a pathophysiological rat model and the underlying mechanisms involved. Before resuscitation, male rats underwent a combination of induced portal hypertension, applying an abdominal restraint device, and hemorrhaging to mean arterial pressure (MAP) of 40mmHg for 2h...
August 2016: Free Radical Biology & Medicine
Bruce Kinosian, George Taler, Peter Boling, Dan Gilden
The Independence at Home (IAH) Demonstration Year 1 results have confirmed earlier studies that showed the ability of home-based primary care (HBPC) to improve care and lower costs for Medicare's frailest beneficiaries. The first-year report showed IAH savings of 7.7% for all programs and 17% for the nine of 17 programs that surpassed the 5% mandatory savings threshold. Using these results as applied to the Medicare 5% claims file, the effect of expanding HBPC to the 2.2 million Medicare beneficiaries who are similar to IAH demonstration participants was projected...
August 2016: Journal of the American Geriatrics Society
E Asbach, T A Williams, M Reincke
Primary aldosteronism (PA) is the most frequent endocrine cause of secondary arterial hypertension. Sporadic forms of PA caused mainly by an aldosterone producing adenoma (APA) or idiopathic adrenal hyperplasia (IAH) predominate; in contrast, familial forms (familial hyperaldosteronism types I, II and III) affect only a minor proportion of PA patients. Patient based registries and biobanks, international networks and next generation sequencing technologies have emerged over recent years. Somatic hot-spot mutations in the potassium channel GIRK4 (encoded by KCNJ5), in ATPases and a L-type voltage-gated calcium-channel correlate with the autonomous aldosterone production in approximately half of all APAs...
June 2016: Experimental and Clinical Endocrinology & Diabetes
Bernhard J Hering, William R Clarke, Nancy D Bridges, Thomas L Eggerman, Rodolfo Alejandro, Melena D Bellin, Kathryn Chaloner, Christine W Czarniecki, Julia S Goldstein, Lawrence G Hunsicker, Dixon B Kaufman, Olle Korsgren, Christian P Larsen, Xunrong Luo, James F Markmann, Ali Naji, Jose Oberholzer, Andrew M Posselt, Michael R Rickels, Camillo Ricordi, Mark A Robien, Peter A Senior, A M James Shapiro, Peter G Stock, Nicole A Turgeon
OBJECTIVE: Impaired awareness of hypoglycemia (IAH) and severe hypoglycemic events (SHEs) cause substantial morbidity and mortality in patients with type 1 diabetes (T1D). Current therapies are effective in preventing SHEs in 50-80% of patients with IAH and SHEs, leaving a substantial number of patients at risk. We evaluated the effectiveness and safety of a standardized human pancreatic islet product in subjects in whom IAH and SHEs persisted despite medical treatment. RESEARCH DESIGN AND METHODS: This multicenter, single-arm, phase 3 study of the investigational product purified human pancreatic islets (PHPI) was conducted at eight centers in North America...
July 2016: Diabetes Care
Deepa M Patel, Michael J Connor
Intra-abdominal hypertension (IAH) and abdominal compartment syndrome are increasingly recognized in both medical and surgical critically ill patients and are predictive of death and the development of acute kidney injury. Although there are many risk factors for the development of IAH, in the era of goal-directed therapy for shock, brisk volume resuscitation and volume overload are the most common contributors. Abdominal examination is an unreliable predictor of intra-abdominal pressure (IAP), but IAP can be easily measured in a reproducible and reliable manner by a number of simple bedside techniques...
May 2016: Advances in Chronic Kidney Disease
Leanne Hunt, Steven A Frost, Phillip J Newton, Yenna Salamonson, Patricia M Davidson
BACKGROUND: Intra-abdominal hypertension and abdominal compartment syndrome are potentially life threatening conditions. Critical care nurses need to understand the factors that predispose patients to intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS). Predicting and managing IAH and ACS are important to improve health outcomes. AIM: The aim of this paper was to (1) assess the knowledge of Australian critical care nurses about current IAH and ACS practice guidelines, measurement techniques, predictors for the development of IAH and ACS and (2) identify barriers in recognizing IAH, ACS and measuring IAP...
March 29, 2016: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
Patrick Maluso, Jody Olson, Babak Sarani
Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are rare but potentially morbid diagnoses. Clinical index of suspicion for these disorders should be raised following massive resuscitation, abdominal wall reconstruction/injury, and in those with space-occupying disorders in the abdomen. Gold standard for diagnosis involves measurement of bladder pressure, with a pressure greater than 12 mm Hg being consistent with IAH and greater than 25 mm Hg being consistent with ACS. Decompressive laparotomy is definitive therapy but paracentesis can be equally therapeutic in properly selected patients...
April 2016: Critical Care Clinics
Boris Cheval, Remi Radel, Emmanuelle Grob, Paolo Ghisletta, Francesco Bianchi-Demicheli, Julien Chanal
INTRODUCTION: Some models suggest that homophobia can be explained as a denied attraction toward same-sex individuals. While it has been found that homophobic men have same-sex attraction, these results are not consistent. AIM: This study drew on the dual-process models to test the assumption that sexual interest in homosexual cues among men high in homophobia will depend on their specific impulses toward homosexual-related stimuli. METHODS: Heterosexual men (N = 38) first completed a scale measuring their level of homonegativity...
May 2016: Journal of Sexual Medicine
Evita C Wiegers, Hanne M Rooijackers, Cees J Tack, Arend Heerschap, Bastiaan E de Galan, Marinette van der Graaf
Brain lactate may be involved in the development of impaired awareness of hypoglycemia (IAH), a condition that affects approximately 25% of patients with type 1 diabetes and increases the risk of severe hypoglycemia. The aim of this study was to investigate the effect of acute hypoglycemia on brain lactate concentration in patients with IAH as compared with those with normal awareness of hypoglycemia (NAH) and healthy control subjects (n = 7 per group). After an overnight fast, all subjects underwent a two-step hyperinsulinemic euglycemic (5...
June 2016: Diabetes
Yuxin Leng, Min Yi, Jie Fan, Yu Bai, Qinggang Ge, Gaiqi Yao
Intra-abdominal hypertension (IAH) is a common and serious complication in critically ill patients for which there is no well-defined treatment strategy. Here, we explored the effect of IAH on multiple intestinal barriers and discussed whether the alteration in microflora provides clues to guide the rational therapeutic treatment of intestinal barriers during IAH. Using a rat model, we analysed the expression of tight junction proteins (TJs), mucins, chemotactic factors, and Toll-like receptor 4 (TLR4) by immunohistochemistry...
2016: Scientific Reports
I V Khomyak, Yu O Furmanov, I M Savytska, O V Kit, A I Khomyak
In experiment the impact of intraabdominal hypertension (IAH) on an acute pancreatitis (AP) course was studied up. The procedure of an acute experiment, using intraparenchymatose introduction of 40% solution of ethanol, was proposed. The isolated influence of IAH on target organs was investigated, as well as its impact on the simulated severe AP course. Morphological changes in pancreas, small intestine, kidneys, liver in an AP were studied up. While performing the investigation a negative impact of IAH in AP was noted, such as the polyorgan insufficiency occurence...
October 2015: Klinichna Khirurhiia
Hua-Yu Zhang, Dong Liu, Hao Tang, Shi-Jin Sun, Shan-Mu Ai, Wen-Qun Yang, Dong-Po Jiang, Jian Zhou, Lian-Yang Zhang
PURPOSE: To investigate the prevalence and diagnosis rate of intra-abdominal hypertension (IAH) in a mixed-population intensive care unit (ICU), and to investigate the knowledge of ICU staff regarding the guidelines published by the World Society of Abdominal Compartment Syndrome (WSACS) in 2013. METHODS: A one-day cross-sectional study based on the WSACS 2013 guidelines was conducted in the general ICU of a tertiary teaching hospital in Chongqing, China. The included patients were divided into intravesical pressure (IVP) measured group and IVP unmeasured group...
2015: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
Jiten Jaipuria, Vimal Bhandari, Avneet Singh Chawla, Mohit Singh
AIM: To systematically review evidence on pathophysiology of intra-abdominal pressure (IAP) in acute pancreatitis (AP) with its clinical correlates. METHODS: Systematic review of available evidence in English literature with relevant medical subject heading terms on PubMed, Medline and Scopus with further search from open access sources on internet as suggested by articles retrieved. RESULTS: Intra-abdominal hypertension (IAH) is increasingly gaining recognition as a point of specific intervention with potential to alter disease outcome and improve mortality in AP...
February 15, 2016: World Journal of Gastrointestinal Pathophysiology
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